Condylomata of the cervix

Condyloma of the cervix is one of the most common viral lesions of the female genital organs. Most of these diseases can cause female infertility. The other part of the diseases is background or precancerous conditions. Given this fact, the issue of timely diagnosis and treatment of diseases of female genitalia is a priority for the preservation of the population.

[1], [2], [3], [4], [5], [6], [7], [8], [9],

Epidemiology

The prevalence of female genital diseases ranks first among all diseases in women of childbearing age.

[10], [11], [12], [13], [14], [15], [16]

Causes of the cervical warts

Causes of condyloma of the cervix are viral particles that fall on the mucous membrane of the female genital organs. There are more than one hundred types of human papillomavirus. The main feature of some types is oncogenicity - the virus's ability to provoke the development of cancer to a greater extent than others. Oncogenic types of human papillomavirus are HPV 16, 18, 31, 33, 35, 39, 45, 51 and others.

The main way of transmission of the virus is the contact one, in this case, the sexual one. But infection with the virus can not always lead to the development of the disease, this is due to the characteristics of female genital organs. The secret that is secreted by the glands of the vagina, has a weakly acid medium, which is fatal to many viruses and bacteria. Human papillomavirus is a DNA-capacious virus that has a reliable protein envelope with a good defense mechanism. These properties help the virus enter epithelial cells and live there for a long time. At a convenient time, when the concentration of local immune mechanisms decreases, the virus begins to multiply actively. Therefore, the causes of cervical warts are not only the virus itself, but also a decrease in immune mechanisms that allow the virus to multiply.

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Pathogenesis

The pathogenesis of cervical warts is fairly simple and is based on the defeat of the epithelial cell virus. The papilloma virus contacts the mucous membrane of the female genital organs. After this, the virus particle penetrates the epithelial cell. But this can not always lead to the appearance of symptoms of the disease, since the virus can persist in the cell for a long time.

The incubation period ranges from several days to several years. In another case, the disease can manifest immediately. When a virus enters the cell, it penetrates into the nucleus of the cell and destroys the structure of the cellular DNA. Instead of DNA normal epithelial cells, the virus builds in its own DNA. This happens with many neighboring cells. As a result of this process, the cell starts to work incorrectly and unprogrammed cell division begins. All these cells proliferate, hyperplasia and characteristic warts arise. These cells can be of various sizes, depending on the number of cells affected by the virus. Since this is a benign process, condyloma does not penetrate the basal membrane, but grows only in the lumen. The size of the condyloma depends on the number of cells formed. 

[18], [19], [20]

Symptoms of the cervical warts

By the type of predominant cellular elements and the character of morphological changes, the flat and pointed condylomas of the cervix are distinguished. Symptoms of cervical warts, depending on the type, are somewhat different. In most cases, the disease occurs without any visible symptoms. This is explained by the localization of the process, which can not be determined with the naked eye. Symptoms can occur when a woman becomes pregnant, and then serious problems will arise. But as the growth of condyloma can cause the appearance of symptoms.

The main symptoms of cervical warts:

•  pain or discomfort during intercourse;
•  trauma and bleeding;
•  cosmetic defect with a large size of condyloma;
•  obstruction to normal childbirth;
•  detection with a planned gynecological examination.

The first signs of cervical warts appear, if the process has reached significant dimensions. Most often, it all starts with a slight bleeding in the wounds of a condyloma. It can be after sexual intercourse. The process of sexual intercourse can also cause discomfort and unpleasant sensations. If such symptoms appear, then it is necessary to consult a doctor.

Often women are treated with a fairly common problem - infertility. One of the reasons can also be warts of the cervix, which prevents the normal passage of spermatozoa.

Symptoms of cervical warts can also appear for the first time in childbirth. Then there is an obstacle, and the child can not normally pass through the birth canal or the condyloma itself is injured and causes bleeding. The child can also become infected with the virus when passing through the birth canal.

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Forms

[23]

Flat condyloma of the cervix

Flat condyloma of the cervix is one of the most dangerous manifestations of infection with this virus. This is due to the fact that the appearance of flat condyloma indicates a chronic infection and the presence of the virus for a very long time. A feature of flat condyloma is the fact that the virus multiplies in deep spheres of the epithelium. Atypical cells that are formed when infected with a virus are very difficult to identify. They do not rise above the surface of the epithelium, unlike peaked, do not have any characteristic color and often small in size. There are data that only flat condyloma can have symptoms in the form of soreness, burning, itching, due to a deep penetration into the epithelium to nerve cells. All this presents a danger due to late detection and untimely treatment. Flat condyloma of the cervix is often malignant. This presents an even greater danger. At simple survey such condyloma is extremely difficult to find out, therefore use additional methods. The mucous membrane is stained with Lugol's solution or acetic acid solution, then the area with condyloma looks colorless against the background of colored surrounding epithelial cells. To confirm the aetiology, condylomas must be biopsied.

[24], [25], [26], [27], [28]

Genital warts of the cervix

Unlike flat warts, genital warts of the cervix testify to the acute course of the viral process. They, as a rule, arise simultaneously and look like growths on a short stem in the form of sea kale. Genital warts are arranged as single entities or as aggregated clusters. On the epithelium, they often have a pale pink color. These sprains are injured and cause the above symptoms. A characteristic symptom of such condylomas is itching and burning in the genital area, and if the integrity of the epithelium is violated, it can bleed. In terms of diagnosis, genital warts are clearly visible on examination, which increases the number of detections of this type of genital warts. When gynecological examination, they have a characteristic appearance, grow into the lumen of the organ, can be arranged by a group or be single. Genital warts are superficial, because the virus multiplies in the upper layers of the epithelium. In terms of treatment, these condylomas are more favorable and more amenable to treatment due to exophytic growth. It should also be noted that, in the absence of adequate and timely treatment, genital warts tend to spread. In the neighboring areas, similar changes quickly appear, and condylomas can later be on the mucous membranes of the vulva or external genitalia.

Condylomata on the cervix

Condylomata on the cervix are very frequent, but at the same time dangerous localization. By localization, condylomas are distinguished on the vulva, in the vagina, on the cervix, on the labia. Of all the variants of condyloma on the cervix, the most unfavorable. With such a localization, it is very difficult to diagnose them and therefore they are detected in the late stages. This localization is dangerous in terms of malignancy, and can also be a cause of a violation of the physiological course of pregnancy and childbirth. The cervix is sensitive to many female sex hormones, and under the influence of these hormones, condylomas can grow to considerable sizes, and their instability in the development of oncopathology increases. Condylomata of the cervix can cause female infertility, because it is the cervix that passes a certain amount of sperm, and with condyloma there is an obstruction to a normal sexual intercourse.

Often this reason is not taken into account, although it may be the only one. The virus is still in the cells that it has infected and can in the future infect the fetus if pregnancy has occurred. Condylomata located on the cervix by structure, in most cases, are flat, which further complicates their diagnosis and treatment. Such localization is difficult for free access and treatment methods are limited here. Condylomas of the vulva, labia or vagina are more accessible to examination, treatment.

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Complications and consequences

As you know, cervical warts are not so dangerous by their course, as dangerous consequences. The human papilloma virus, which is the aetiological factor of condyloma, is very dangerous. He does not always lead to symptoms after infection, but can simply sit inside the cage and wait for a convenient moment to activate the process of cell division. That's why this virus is dangerous. It is not known how the cell will behave with such a reorganization of its nuclear apparatus. In most cases, condylomas are benign. However, at any time the virus can initiate uncontrolled cell division, and the process will become malignant. Depending on what type of virus caused condyloma, the likelihood of malignancy varies. If the pathogen is an oncogenic type of virus, then the probability of oncology is great. Therefore, one of the most serious complications is the transformation of condyloma into cervical cancer. A higher percentage of malignancy occurs with flat warts of the cervix, which is a deeper process.

Consequences and complications of cervical warts are not only a cancerous degeneration. There are other possible complications: bleeding in the trauma of condyloma, complications in childbirth, violation of ovario-menstrual function. If the integrity of the condyloma is broken and infection occurs with its bacterial flora, an infectious process can develop.  

[33], [34], [35]

Diagnostics of the cervical warts

Diagnosis of cervical warts should be complete and complex to choose the right treatment.

When there are any symptoms of diseases of female genitalia, it is necessary to consult a specialist. The history of the disease helps to establish the possible nature of the process, the source of infection, possible other bacterial infections, the degree of disruption of the general condition of the patient.

Upon examination, the doctor can diagnose changes in the integrity and color of the epithelial cover of the cervix, the presence of growths, their number and nature. On examination, a smear from the cervix is also taken and sent for bacterial and morphological examination.

After examination and with suspicion of cervical warts, the doctor conducts instrumental and laboratory examinations.

Analyzes that need to be handled are a general analysis of blood and urine, a swab of the vagina. Be sure to conduct a biopsy of the condyloma, or after the surgical removal of it is sent to a morphological examination. This analysis indicates which cells in the biopsy specimen, the degree of their dysplasia, the depth of infestation, and also confirms the benign nature of the formation. From the biopsy specimen, in the case of a virus in the cells, it is necessary to determine what type of human papillomavirus is in the particular case the causative agent (we are afraid of oncogenicity). Determination of the type of virus can be done by polymerase chain reaction, but it is very difficult to determine the type.

Among the instrumental methods of diagnosis, colposcopy is used. This method makes it possible to see the mucous membrane of the cervix with illumination tenfold, the changes on the mucous are clearly visible. You can immediately take a biopsy of the necessary site.

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Treatment of the cervical warts

Treatment of cervical warts condyloma depends on the type - peaked or flat condyloma - the size of condyloma, the age of the woman, the degree of symptoms. Given the fact that human papillomavirus is associated with the development of cervical cancer in women, condyloma in any case must be treated. Self-healing or involuntary condyloma does not happen.

The mode is general, because the general state is broken. It is recommended before the treatment and for the period of treatment to limit sexual intercourse for the prevention of trauma to genital warts.

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There are medicinal methods of treatment, operational and alternative means.

Medication is used for small sizes and for initial manifestations. Since the causative agent of the virus - use parenteral antiviral agents, immunoglobulins. But an antiviral drug with proven action against this virus does not exist, so this treatment is nonspecific. Use drugs such as "Genferon", "Panavir", which stop the reproduction of the virus and have an immunomodulatory effect.

You can use medicines external application - the drug "podophyllin" is smeared on the condyloma once a day and the number of cells is somewhat reduced. It is also possible medicamental cauterization of 10% trichloroacetic acid. This treatment is used once a week and repeated until the cell mass decreases. There is another specialized preparation for cauterization - "Solkagin". It has no toxic effect on the surrounding healthy epithelium.

It should be remembered that prolonged conservative treatment is inappropriate, if it does not bring an effect, because with each deceleration the percentage of possible malignancy increases.

Alternative treatment of cervical condyloma

The prevalence of pathology and the severity of the problem forced us to look for alternative therapies. To date, alternative curing of cervical wartoma includes the use of homeopathic remedies, herbal treatments and home-made tools.

There are methods in which use at home for cauterization of iodine, celandine solution, propolis. But it is not recommended to do this at home in the genital area, as it can cause a chemical burn.

Among other alternative means use the following methods:

1. Rubbing condyloma with garlic or compresses at night from garlic.
2. Lubrication of the warts by egg white.
3. Compresses from onions soaked in vinegar, put on the night.
4. Flour and vinegar are mixed and the resulting dough is applied to condylomas until the dough dries

Herbal treatment also proves its effectiveness. Main recipes:

1. Plantain leaf, horsetail, nettle leaves and lemon balm, dandelion root should be poured with one liter of water and boil. After this, you need to insist a decoction 3-4 hours and take in the morning before eating a teaspoon.
2. Cones of hops, valerian, lime, coriander, motherwort and oregano must be poured with a liter of hot water and after being infused, drink in the morning and in the evening 2 teaspoons.
3. Grass of the soul, birch buds, leaves of St. John's wort, calendula, chamomile, celandine, lime and string are poured with boiling water, insist and drink half a glass 4 times a day.

As for homeopathy, the main means are as follows. Suppositories "Papillocan" stimulate the involution of condyloma by stimulating the reverse development of growths. In addition, the drug improves the blood supply of cells, restores trophic disorders and has an anti-relapse effect.

Suppositories "Immuntil" are recommended for the purpose of increasing local immune defense and preventing the activation of the virus.

[38], [39], [40], [41], [42]

Operative treatment of cervical warts

Operative treatment is used if prolonged conservative treatment has not produced a result. Then there is no reason to hesitate, because complications of the disease are possible. Sometimes surgical treatment of cervical warts is used immediately. This happens with a large volume of condyloma, with severe clinical manifestations or with the detection of complications. In most cases, this is though an invasive method, but it is very effective, because atypical cells are completely removed.

Among operational methods, cryodestruction, burning with liquid nitrogen, laser burning, and removal of condyloma are used.

Removal of condyloma is convenient if a condyloma has a well-defined leg and can be easily removed. Then condyloma is sent for histological examination, where the type and nature of tissue dysplasia is determined. Flat warts are not available for easy removal, so other methods of treatment are used for them.

Cauterization of condylomas can be carried out by cryodestruction. Use a cold that freezes condylomas, and they fall away. This procedure is repeated 1-2 times a week, until the condyloma completely disappears. Cauterization with liquid nitrogen acts on the same principle.

Laser therapy using a laser beam can burn condylomas like a scalpel.

Prevention

Given the fact that condyloma of the cervix is associated with the development of cervical cancer, it is very important to prevent disease.

Among the nonspecific methods of prevention, elementary rules of personal hygiene, exclusion of promiscuous sexual acts, timely annual preventive examination in the women's consultation. You need to be attentive to your health.

Specific methods of prophylaxis against certain viruses have been developed.

To date, invented vaccines against the human papilloma virus, some of its types. One of the vaccines "Gardasil" is used against 6, 11, 16, 18 types. It consists of three doses, which must be administered before the onset of sexual activity.

Another vaccine "Cervarix" is also aimed at 16, 18 type. These vaccines create immunity for about 5 years. Therefore, the vaccination method is not absolute in the prevention of genital warts, because infection can happen by another type of virus.

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Forecast

The prognosis of cervical warts for recovery and for life is favorable. This is a benign disease with non-invasive growth. Condylomata are easily treated, well diagnosed with early early treatment.

Condyloma of the cervix is a pathology, which is associated with the development of cervical cancer. But this disease is not so terrible if it is diagnosed in time and treated. With a preventive examination, the warts of the cervix can be found and treated. Surgical treatment promotes complete recovery. It is necessary to give time to one's health, and to prevent diseases better than to treat them later.

[48], [49], [50],