Condylomas
Information on the causes, symptoms, and treatment of genital warts caused by the human papillomavirus.
Symptoms and Causes
Condylomas are warts that appear on the skin of areas that come into contact during sexual activity, usually the genitals and anus, caused by infection with certain types of human papillomavirus (HPV). Only some HPV types cause these lesions, so it is possible to be infected without showing these signs. However, when they do appear, they are due to this disease.
There are different types of condylomas depending on their characteristics and the area of the body affected:
- Acuminated condylomas: the most common type. 90% are caused by HPV strains 6 and 11, with a low risk of progression to cancer. They have an irregular shape and often cluster together. They appear in the genital and anal areas.
- Flat condylomas: small and smooth, these lesions are difficult to detect. They appear on the cervix, vulva, and anus.
- Giant condylomas: uncommon lesions that appear rapidly and grow large enough to affect surrounding organs. Most cases are benign but require prompt treatment due to their size.
The incubation period of HPV ranges from several weeks to months, making it important to notify all previous sexual partners when condylomas are detected.
Symptoms
Most of the time, condylomas are asymptomatic. When symptoms occur, the most common include:
- Itching or burning sensation
- Pain
- Bleeding after vaginal intercourse
- Abnormal vaginal discharge
Causes
Condylomas result from infection with the human papillomavirus.
Risk Factors
The risk of acquiring HPV, and therefore developing condylomas, is higher in the following cases:
- Early onset of sexual activity
- Having multiple sexual partners
- Not using condoms
- Weakened immune system
- Presence of other sexually transmitted infections
Complications
The main complications of condylomas include:
- Secondary bacterial infection of the warts
- Bleeding
- Recurrence after treatment
- HPV infections with types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59 are associated with the development of cervical cancer (the most frequent), as well as vaginal, vulvar, and penile cancers
Prevention
Condylomas can be prevented through:
- Vaccination against HPV: in Spain, a single dose is administered at age 12 to both girls and boys.
- Use of condoms during sexual intercourse: although they do not provide complete protection because they do not cover all areas in contact during sexual activity.
Which Specialist Treats Condylomas?
Condylomas are diagnosed and treated by medical-surgical dermatology and venereology, urology, or gynecology and obstetrics.
Diagnosis
In most cases, condylomas are diagnosed through physical examination. The specialist observes the lesions and, based on their characteristics, confirms the diagnosis. This assessment can be performed using the following procedures:
- Pelvic examination using a speculum to keep the vagina open
- Colposcopy: a stereoscopic microscope with magnifying lenses is introduced into the vagina to examine the cervix
- Proctoscopy: a thin, flexible tube with a light at the tip is used to examine the interior of the anus and rectum
- Anoscopy: similar to proctoscopy but only examines the anal canal; therefore, the probe is shorter
If the warts share features with lesions from other infections, a biopsy is performed for laboratory analysis to determine their origin.
Treatment
Treatment of condylomas involves complete removal. Different techniques can be used:
- Cryotherapy: lesions are destroyed using cold, usually liquid nitrogen
- Conization: a surgical procedure in which the wart is excised along with a portion of healthy tissue in a conical shape
- Laser ablation: a laser scalpel is applied to the condyloma to destroy it
In rare cases, antivirals are administered to strengthen the immune system, as there is no specific treatment for HPV.
