HPV genital warts in men and women

Medically reviewed: 28, December 2023

Read Time:24 Minute

HPV genital warts: Terms and Definitions

HPV genital (venereal) warts, also known as condylomata acuminata, are a contagious viral infection primarily transmitted through sexual activity, caused by the human papillomavirus.

Human papillomavirus (HPV) is the causative agent of genital (venereal) warts, an anthroponotic DNA-containing virus, belongs to the genus of papillomaviruses (Papillomavirus) of the papavavirus family (Papavaviridae).

Genital (venereal) warts are a viral disease, predominantly sexually transmitted, caused by the human papillomavirus and characterized by the appearance of exophytic and endophytic growths on the skin and mucous membranes of the external genitalia, urethra, vagina, cervix, perianal area, anal canal, oropharynx.

HPV-associated diseases caused by the human papillomavirus (HPV) are characterized by damage to the skin and mucous membranes with clinical (manifest) manifestations and/or the formation of HPV-associated conditions and/or diseases (intraepithelial neoplasia).

HPV genital warts and condylomas: Information

List of abbreviations

HIV – human immunodeficiency virus
WHO – World Health Organization
HPV – human papillomavirus
ICD – International Classification of Diseases
PCR – polymerase chain reaction
STIs – sexually transmitted infections
ELISA-enzyme immunoassay

There is no generally accepted classification of genital (venereal) warts:

genital warts;
warts in the form of papules;
lesions in the form of spots.

HPV-associated diseases also include:

intraepithelial neoplasia;
Bowenoid papulosis and Bowen’s disease;
giant Buschke-Levenstein condyloma.

Etiology and pathogenesis of HPV warts

The causative agent of the disease, human papillomavirus (HPV), belongs to the family of papillomaviruses (Papillomaviridae), consisting of 16 genera, representatives of 5 of which are pathogenic for humans.
Alphapapillomavirus (infects oral and urogenital epithelium): HPV 2, 3, 6, 7, 10, 11, 13, 16, 18, 26-35, 39, 40, 42-45, 51-59, 61, cand62, 66- 74, 77, 78, 81-84, cand85-90, 91, 94, PCPV-1, 1C, RhPV-1;
Infect human skin cells:
Betapapillomavirus (HPV 5, 8, 9, 12, 14, 15, 17, 19-25, 36-38, 47, 49, 75, 76, 80, cand92, cand96, BPV-1, BPV-2, DPV, OvPV -1, OvPV-2);
Gammapapillomavirus (HPV 4, 48, 50, 60, 65, 88, 95);
Mupapillomavirus (HPV 1.63);
Nupapillomavirus (causes benign and malignant neoplasms): HPV-41.

The International Agency for Research on Cancer has recognized HPV as the etiological agent of a wide range of cancers, such as cancer of the cervix, vulva, vagina, anal canal, penis, head and neck, as well as genital (venereal) warts, in both men and women, and recurrent respiratory papillomatosis.

Currently, more than 200 genotypes of human papillomaviruses have been identified, of which about 45 HPV genotypes can infect the urogenital tract. HPV is a highly contagious mucosotropic and dermatotropic virus transmitted from person to person through oral, genital and anal sexual contact, as well as through household contact and vertical transmission. Infection of adults occurs through sexual contact (vaginal, anal, oral sex), children – through transplacental (rare), perinatal and genital tracts.

The possibility of autoinoculation and transmission of HPV through household objects remains poorly understood. Medical personnel can become infected with HPV during laser destruction of genital warts by inhaling the resulting smoke containing the virus.

The incubation period of the disease can last from several months to several years. The average time between HPV infection and the development of genital warts ranges from 3 months in women to 11 months in men. Human infection can occur with one or more types of HPV.

During the infection process, the human papillomavirus infects immature cells, most often the basal layer, which then become a constant source of infection of epithelial cells. Infection is facilitated by the presence of microtraumas and inflammatory processes of the infected areas, leading to a decrease in local immunity.

In clinical practice, latent, clinical and subclinical forms of human papillomavirus infection are distinguished. In the cells of the basal layer, the virus can remain latent for a long time and can be determined by molecular biological methods (polymerase chain reaction (PCR)) – in the absence of clinical and cytological changes. As epithelial cells differentiate, transcription of late genes occurs, synthesis of capsid proteins, assembly of virions, destruction of the cell nucleus and lysis of the infected cell, ending with the release of daughter virus particles.

Exposure to various exogenous and endogenous factors leads to increased reproduction of the virus, and the process moves from latent infection to the stage of productive infection, in which clinical manifestations of the disease develop—genital warts or cytological changes induced by HPV (intraepithelial neoplasia (IN) of various degrees: cervical IN (CIN), IN of the vulva (VIN), penis (PIN) and anal area (AIN) and other organs).

With full immune resistance of the body, spontaneous elimination of HPV occurs within 2 years in 90% of infected individuals. In an infected cell, the virus exists in two forms: episomal (outside the cell’s chromosomes), which is considered benign, and intrasomal (integrated, “built-in” into the cell’s genome), which is malignant.

With a long-term persistent course, the development of intraepithelial neoplasia and a cancer process is possible (typical for HPV types that have high transforming activity towards epithelial cells). The development of neoplastic processes caused by HPV infection usually occurs after several years or several decades. At present, there are a total of 15 HPV genotypes that are classified as viruses with a high risk of causing cervical cancer.

These include genotypes 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68, 73, and 82. Additionally, there are 3 genotypes, namely 26, 53, and 66, that are potentially high-risk viruses. On the other hand, there are 12 HPV genotypes that are considered to have a low risk of causing cancer, which are genotypes 6, 11, 40, 42, 43, 44, 54, 61, 70, 72, 81, and SR 6 108.

It is worth noting that HPV types 6 and 11 are responsible for up to 90% of all cases of genital warts in both men and women. In 20-50% of patients with genital warts, high-oncogenic risk HPV is detected.

Epidemiology of HPV genital warts

Human papillomavirus infection is most often recorded in young people who have a large number of sexual partners. According to the World Health Organization (WHO), it is estimated that between 50% and 80% of the global population is affected by the human papillomavirus (HPV). However, it is important to note that only a small percentage, ranging from 5% to 10%, of those infected with HPV actually display noticeable symptoms or clinical manifestations of the disease.

Based on a comprehensive examination of worldwide data, the occurrence of genital warts in both males and females, taking into account new occurrences as well as recurring cases, ranges from 160 to 289 instances per 100,000 individuals in the population. On average, the prevalence stands at 194.5 cases per 100,000 individuals. Additionally, the yearly rate of identifying fresh instances of genital warts is approximately 137 cases per 100,000 males and 120.5 cases per 100,000 females.

In a number of European countries, the incidence in the general population varies between 0.16-0.18% of the total population.

Clinical picture and symptoms of HPV genital warts

Condylomas acuminata are finger-shaped protrusions on the surface of the skin and mucous membranes, having a typical “motley” and/or loop-shaped pattern and localized in the area of the inner layer of the foreskin, glans penis, external opening of the urethra, labia minora, vaginal opening, vagina, cervix, groin, perineum and area of the anus;
Warts in the form of papules are papular rashes without finger-like protrusions, localized on the keratinized epithelium of the outer layer of the foreskin, body of the penis, scrotum, lateral region of the vulva, pubis, perineum and perianal region;
Spot lesions – grayish-white, pinkish-red or reddish-brown spots on the skin and/or mucous membrane of the genital organs;
Bowenoid papulosis and Bowen’s disease – papules and spots with a smooth or velvety surface; the color of the elements in areas of damage to the mucous membrane is brown or orange-red, and the color of lesions on the skin is ash-gray or brownish-black;
Giant Buschke-Levenstein condyloma – small wart-like papillomas that merge with each other and form a lesion with a wide base.

Diagnostics of HPV genital warts

The diagnosis of genital warts is made based on clinical manifestations.

Complaints and anamnesis

Subjective symptoms:

the presence of single or multiple formations in the form of papules, papillomas, spots on the skin and mucous membranes of the genital organs, moderate itching and paresthesia in the affected area are possible;
pain during sexual intercourse (dyspareunia);
when rashes are localized in the urethral area – itching, burning, pain when urinating (dysuria);
with extensive lesions in the urethra – difficulty urinating, hematospermia (blood in semen);
painful cracks and bleeding in the affected areas.

Physical examination

The genital organs, inguinal folds, and perianal area are examined.
In women, examination of the mucous membranes of the vagina and the visible part of the cervix using a Cusco speculum.
All patients undergo an examination of the external opening of the urethra.

Laboratory diagnostic tests

Recommended for the purpose of identifying the HPV genotype of a high oncogenic type to predict the course of the disease and/or, if necessary, clarify the diagnosis:

molecular biological study of discharge from the cervical canal for human papilloma virus (Papilloma virus)
study of vaginal discharge for human papilloma virus (Papilloma virus)
molecular biological testing of urethral discharge for human papilloma virus (Papilloma virus).

There are certain indications that suggest the need for an examination to detect high-risk oncogenic strains of HPV. These indications include the presence of genital warts, as well as the presence of other sexually transmitted infections, in females – pathology of the cervix and/or changes during colposcopic and/or cytological examination, sexual contacts with partners in whom genital warts are detected warts and/or positive molecular biological test results for HPV.

It is recommended to consult an obstetrician-gynecologist and perform a cytological examination of cervical smears for patients in order to exclude cervical itraepithelial neoplasia, if the patient has not had such a study within a year (cervical cancer screening).

A pathological and anatomical examination of biopsy (surgical) material is recommended if it is necessary to exclude non-plastic formations.

If necessary, an immunohistochemical study is performed.

It is recommended that before using methods of physical destruction and surgical excision in order to exclude concomitant pathology, additionally conduct a serological test for syphilis, HIV, hepatitis B and C:

determination of antibodies to pale treponema (Treponema pallidum) by enzyme immunoassay (ELISA) in the blood) or determination of antibodies to pallidum treponema (Treponema pallidum) in non-treponema tests (RPR, RMP) (qualitative and semi-quantitative research) in blood serum;
The identification and measurement of antibodies belonging to the M and G classes (specifically IgM and IgG) against the human immunodeficiency virus HIV-1, also known as Human immunodeficiency virus HIV 1, within the bloodstream; determination of antibodies of classes M, G (IgM, IgG) to the human immunodeficiency virus HIV-2 (Human immunodeficiency virus HIV 2) in the blood;
determination of the antigen (HbsAg) of the hepatitis B virus in the blood and determination of the antigen of the hepatitis C virus in the blood.

Other diagnostic tests for HPV warts

It is recommended to carry out a test with a 5% solution of acetic acid (prepared extemporaneously) in order to visualize genital warts and clarify the boundaries of the lesion when assessing clinical manifestations is difficult.

After the test, vulvoscopy can be used. The method can be used not only for visualization purposes, but also to clarify the boundaries of the lesion during destructive therapy and/or determine the location of a targeted biopsy.

A consultation with an obstetrician-gynecologist is highly recommended for the purpose of diagnosing dysplastic processes of the cervix, vulva and vagina; for the management of pregnant women, patients with genital warts and women during lactation.

Treatment of HPV genital warts

There are several approaches to removing genital warts; any surgical method of removing warts leads to their complete disappearance, but none of these methods completely eliminates the risk of relapse, since removing the growths does not mean eliminating the HPV that caused the development of these tumors.

Treatment methods for warts do not depend on the location of the process. There are no fundamental differences in the treatment of genital warts and warts of other localizations. The type of HPV does not matter when choosing a treatment method for viral warts.

1. Conservative treatment

To treat genital (venereal) warts, destructive methods of therapy are used.

Chemical methods of destruction are recommended to remove genital (venereal) warts:

1.5% solution of zinc chloropropionate in 50% 2-chloropropionic acid, topical solution, is applied using a wooden spatula with a pointed tip (on genital warts with a diameter of 0.1 to 0.5 cm) or a glass capillary ( for genital warts with a diameter exceeding 0.5 cm). In some cases, to achieve complete mummification of the tissue of genital warts, it is necessary to carry out up to 3 application sessions with a frequency of 1 time every 5-7 days.

Before applying the drug, the surface to be treated is first degreased with a 70% ethanol solution for better penetration of the drug. The solution is applied to the rash once until the color of the tissue changes to grayish-white. The drug is not reapplied until the mummified scab is separated.

Contraindicated in case of malignant neoplasms of the skin and mucous membrane, a pronounced tendency to form keloids, pregnancy, breastfeeding, age under 18 years, hypersensitivity to the components of the drug. In the presence of extensive lesions, treatment with the drug is carried out in several stages with an interval of at least 24 hours. During each procedure, no more than 2-3 lesions with a total area of up to 3 cm2 can be treated.

Or a chemical method of destructive therapy can be used to remove genital (venereal) warts:

A combination of nitric, acetic, oxalic, lactic acids and copper nitrate trihydrate (solution for external use) – applied once directly to genital warts using a glass capillary or plastic spatula, without affecting healthy tissue.

Do not treat a surface larger than 4-5 cm2, the break between procedures is 1-4 weeks. The drug is contraindicated for malignant skin tumors and should not be used in patients with a strong tendency to form scar tissue. In children over 5 years of age, it is used without restrictions, in compliance with current recommendations. During pregnancy and lactation, drug therapy is prescribed only if the potential benefit to the mother exceeds the possible risk to the fetus.

Pregnant women can be treated up to 36 weeks of pregnancy using cryodestruction, laser destruction or electrocoagulation with the participation of obstetricians and gynecologists. For extensive genital condylomas – surgical delivery (to prevent laryngeal condylomatosis in a newborn).

Physical methods of destruction are preferred since they do not cause toxic side reactions for the treatment of genital warts in children.

In case of recurrence of clinical manifestations of the disease, repeated destruction of genital warts can be performed with the use of interferons and other antiviral drugs. Preparations containing interferon-alpha-2b, recombinant human interferon-gamma, inosine pranobex or potato shoot polysaccharides are used.

Photodynamic therapy is recommended for multiple genital urethral warts. Therapeutic effects are carried out under local anesthesia. The effectiveness of the method according to a randomized study 6 months after treatment is 85.7%. Serious pain during the procedure occurs in only 1.8% of cases.

2. Surgical treatment

Surgical treatment includes excision and/or destruction of genital warts using various methods: acute, electrocoagulation, laser, radiosurgical device, etc. The relapse rate ranges from 17-29% without significant differences among the surgical treatment methods used:

Physical methods of destructive therapy with preliminary superficial or infiltrative anesthesia of the skin are recommended in order to remove genital (venereal) warts:
Electrocoagulation
Laser destruction of skin tissue. The method is preferable for use in children as well.
Radiofrequency thermal ablation.
Cryodestruction of affected skin. The method is most effective for single, small-sized formations. Relapse of the disease after cryodestruction is observed in 31-40% of patients.

Regardless of the method of destruction used, 20-30% of patients may develop new lesions on the skin and/or mucous membranes of the genital area. In the absence of genital warts or cervical squamous intraepithelial lesions, treatment of subclinical genital papillomavirus infection is not carried out.

The indication for surgical treatment is the ineffectiveness of conservative and minimally invasive treatment, suspicion of malignancy. Surgical interventions are performed as planned. It is not advisable to postpone radical treatment due to the risk of malignancy of the process.

The choice of method of operation (removal) is determined based on the following characteristics:

affected area;
presence or absence of damage to the anal canal;
presence or absence of suspicion of malignancy of the process.

Surgical excision is recommended for extensive lesions of the skin surface due to the destructive growth of giant Buschke-Levenstein condyloma.

In patients with a Buschke-Levenshtein tumor, it is necessary to excise the tissues involved in the process, departing at least 0.5 cm from the base of the formation. In this case, defects of significant area are often formed, requiring the use of plastic methods (V-Y skin grafting, the use of free grafts)

If the area of damage is large, or in the presence of condylomas in the anal canal, surgical excision by acute means, laser destruction or radiosurgical destruction must be performed under spinal anesthesia.

Method of acute excision of condylomas:

Superficial or infiltrative anesthesia of the skin can be used for such type of surgery. If the affected area is large or if there are condylomas in the anal canal, use spinal anesthesia. The relapse rate is 19-29%. The method does not require special equipment and is simple to perform. Disadvantages: the need to stitch bleeding wounds, postoperative pain syndrome, especially during operations on the anal canal.

For genital localization, the operation should be done under spinal anesthesia. A standard set of surgical instruments, a monopolar electrocoagulator with standard attachments, or a radio wave surgical generator are used. The incidence of disease relapse after excision of condylomas is 28-51%.

Removal with electrosurgical instrument.

This type of surgery can be performed under local anesthesia. With a large area of damage or in the presence of condylomas in the anal canal – under spinal anesthesia. The relapse rate is 22%.

Removing HPV warts with laser technology.

The operation is performed under superficial or infiltrative skin anesthesia. In case of a large area of lesion or in the presence of condylomas in the anal canal – under spinal anesthesia. The recurrence rate is 17-19% and is comparable to other methods of surgical removal of AGB.

With uretral warts, the surgery is done under superficial anesthesia. The relapse rate with the use of Nd:YAG laser reaches 34-47%, but with the use of photodynamic control it decreases to 21%. The use of a thulium laser can reduce the relapse rate by half.

Treatment of pregnant women with HPV genital warts

Therapy for pregnant patients can be carried up to 36 weeks, with preference given to physical methods of destruction – laser ablation, electrocoagulation and cryodestruction. Treatment is recommended to be carried out with the participation of obstetricians and gynecologists.

Rehabilitation after HPV genital warts removal

In most cases, after removal of warts from anal and genital areas, rehabilitation is not required.

Rehabilitation is indicated after surgery for the removal of condylomas over a large area involving the anorectal area or urethra.

The need for rehabilitation of patients who have undergone surgical treatment for genital perianal condylomas and anal canal condylomas is due to surgical trauma to these areas. The presence of postoperative wounds (violation of integrity) in these anatomical areas, especially with a large area of damage, and their healing by secondary intention, cause the risk of purulent-septic complications.

Pain symptoms of varying severity and possible dysfunction of defecation and urination in the postoperative period can lead to significant social maladjustment and reduce the quality of life of this category of patients.

The goal of rehabilitation of patients who have undergone surgery is the complete social and physical recovery of the patient. Particular attention should be paid to patients who have undergone surgery on the anal canal and extensive plastic surgery on the perianal area, since the function of anal continence may suffer. Removal of urethral condylomas may be accompanied in the long term by the formation of its stricture.

Stage 1 – early rehabilitation, from 4-6 to 7-10 days after surgery. During this period, the patient is undergoing inpatient rehabilitation treatment for 3-5 days, after which further rehabilitation occurs for 7-14 days on an outpatient basis. The most important tasks of the 1st stage of rehabilitation are the normalization of the gastrointestinal tract with the formation of normal stool consistency and frequency. In addition, at this stage, control of hemostasis, wound process and relief of postoperative pain syndrome is carried out.

Stage 2, from 15 to 45 days after surgery, is aimed at accelerating reparative processes and healing of postoperative wounds, controlling the activity of the gastrointestinal tract. The criterion for completing rehabilitation is complete healing of postoperative wounds of the perineum, anal canal and urethra. Throughout the postoperative period patients should follow a diet with the consumption of an adequate amount of fluid and dietary fiber and take medications that promote regular and complete bowel movements (the most commonly used are plantain oval seed shell, lactulose, macrogol), eliminating the need for straining to empty the rectum, limiting physical loads associated with increased intra-abdominal pressure and tension in the pelvic floor muscles.

After discharge from the hospital, during the period of wound healing, patients should be under the supervision of a coloproctologist, or an obstetrician-gynecologist, or an outpatient surgeon.

In the absence of complete epithelization on the 45th day after surgery, the wound should be considered long-term non-healing. In these cases, it is necessary to conduct: microbiological examination of wound discharge, consultation and observation by a physiotherapist.

Additional information affecting the course and outcome of the disease

Genital (venereal) warts are subject to registration in federal statistical surveillance forms.

Negatively affect the outcome of treatment and increase the risk of HPV infection:

a large number of sexual partners (more than 3 during the last year, more than 6 during sexual life;
anal intercourse, especially among men who have sex with men;
concomitant sexually transmitted infections, especially those caused by herpes simplex virus type 2,
cytomegalovirus, chlamydia, genital mycoplasma;
immunodeficiency states, especially HIV-induced immunodeficiency;
diseases of the cervix (erosions, polyps of the cervical canal, leukoplakia, endometriosis);
long-term use of oral and injectable contraceptives, which increase the expression of HPV genes in cervical epithelial cells due to their effect on hormone-sensitive elements in the viral genome;
hyperprolactinemia, as a factor stimulating cell proliferation;
childbirth at a young age (before 16 years), injuries during childbirth, abortion, insertion of intrauterine devices, due
to which the innervation, reception and trophism of tissues in the cervix are disrupted;
hereditary predisposition to cancer of the reproductive system;
smoking, since cigarette combustion products are concentrated on the mucous membranes, including the cervix, leading to suppression of the immune activity of Langerhans cells;
lack of medical supervision and non-compliance with doctor’s recommendations.

Hospitalization of patients with HPV warts

Treatment is mainly carried out on an outpatient basis in a medical institution with a dermatovenerological profile. When genital (venereal) warts are localized on the rectal mucosa, treatment is carried out in a coloproctological medical facility. When visiting pregnant women, with extensive lesions on the mucous membrane of the cervix – in a medical institution with an obstetric and gynecological profile, with intraurethral localization – in a urological institution.

Indications for hospitalization in a medical organization:

damages on the affected areas for the purpose of surgical excision and subsequent pathological and anatomical examination of the surgical material.

Prevention of HPV anal and genital warts

exclusion of casual sexual contacts;
use of barrier contraception;
examination and treatment of sexual partners.

One of the methods of specific primary prevention of HPV-associated pathology is vaccination against human papillomaviruses of various genotypes.

Vaccinal HPV prevention

The vaccine against human papillomavirus, quadrivalent, recombinant (types 6, 11, 16, 18) is recommended for the prevention of cancer and precancerous lesions of the cervix, vulva, vagina, anal cancer and genital warts in women, as well as for the prevention of anal cancer and genital warts in men aged 9 to 26 years.

The vaccine is purely preventive and has no therapeutic effect. Vaccination is recommended before the onset of sexual activity; both vaccines are exclusively preventive, do not have a therapeutic effect, and do not protect against all highly oncogenic HPVs, although they have cross-efficacy against some highly oncogenic HPV genotypes – 31, 33, 45.

Among persons uninfected with HPV, the vaccine against human papillomavirus, quadrivalent, recombinant, provides almost 100% protection against genital warts associated with HPV types 6 and 11 and about 83% against all genital warts.

General recommendations after treatment:

During the period of treatment and clinical observation, it is necessary to abstain from sexual intercourse or use barrier methods of contraception until cure is established.
Examination and treatment of sexual partners is recommended.
In order to establish cure, a second visit to the doctor is required 7 days after the destruction.
Screening for other sexually transmitted infections is recommended.

Questions to doctor about HPV genital warts

What are genital warts?

Genital warts form on the skin and mucous membrane of the external genitalia and anal area due to infection with human papillomaviruses.

How genital warts develop?

Genital warts are an infectious disease caused by the sexually transmitted human papillomavirus (HPV types 6 and 11).

The incubation period (the time elapsed from infection to the appearance of the first signs of the disease) can last up to eight months.

Most HPV infections are asymptomatic and there may be no symptoms on the skin for up to 2 years. This means that you may not know that you are a carrier of the infection and can infect another person.

The virus can persist in human skin for several months or years, asymptomatically or with symptoms. Up to 30% of women aged 20 to 30 years become infected with this infection; Older women are less likely to become infected.

Can genital warts be hereditary?

No.

What are the signs and symptoms of genital warts?

The presence of warts on the external genitalia (ano-genital zone) is almost always determined by a woman herself. Usually they are without subjective sensations, but can cause some itching.

Internal warts appear inside the genitals, such as on the cervix, vagina, or inside the anus. They usually appear asymptomatically, but sometimes cause itching in the vagina, in the anal area or discomfort when urinating, and very rarely bleeding.

What do genital warts look like?

Genital warts are small, warty growths, although some have a smooth surface. They may be darker than the surrounding skin.

How to make a diagnosis?

Genital warts are clearly visible upon clinical examination.

In case of an inaccurate diagnosis, if treatment has not led to the disappearance of genital warts, if they are darker than the surrounding skin, with ulceration or have a dense structure, then a biopsy is necessary.

Examination of the vagina and cervix may reveal genital warts in the vagina and cervix.

The manifestation of clinical signs depends on the human immune system. During pregnancy, the mother’s immune system is weakened, so genital warts can easily appear and become a serious problem. They may disappear on their own, but appear again after childbirth.

Can genital warts be cured?

Yes, but sometimes it is difficult to know whether the virus has been completely eradicated. Constant or recurrent appearance of genital warts often require repeated treatment; relapses occur even months or years later.

Are genital warts contagious?

Genital warts are very easily transmitted. The use of condoms is the only way to prevent sexual transmission, although it does not provide complete protection. The risk of transmission increases with a large number of sexual partners.

How should genital warts be treated during pregnancy?

Large genital warts can occur in pregnant women. They may be accompanied by pain, infection, bleeding, and discomfort during urination, sexual intercourse, and bowel movements. It is necessary to examine the cervix.

The choice of treatment depends on the type, size and location of the wart. Treatment should be carried out in the early stages of the disease. However, in the last eight weeks of pregnancy, wart removal methods that can damage large areas of skin should be avoided before delivery.

There are several methods of treating genital warts. Cryotherapy – removal of condylomas with liquid nitrogen, electrosurgery and radiosurgery. These procedures must be performed by a doctor.

After childbirth, the woman’s immunity is restored, and genital warts often disappear.

Genital warts are easily transmitted, and their complete disappearance is doubtful. Progression of the disease can lead to extensive lesions, so treatment is recommended.

How do genital warts affect a child?

The child is not infected with genital warts. Maternal antibodies against HPV are passed on to and protect the baby, so the risk of the baby contracting HPV during birth is very low. The only serious and rare complication is “juvenile laryngeal papillomatosis” (numerous warts on the vocal cords). The period of labor should be kept as short as possible using vaginal antiseptics; in this case, caesarean section is not necessary because it does not completely protect against the risk of transmission of infection.

Examination of the male partner and his treatment. Similar diagnostic and treatment options are used for both men and women. Male partners with genital warts are referred for treatment to a dermatovenerologist or urologist.