Cervical condyloma

Cervical condyloma is one of the most common viral lesions of the female genital organs. Most of these diseases can cause female infertility. Another part of the diseases are background or precancerous conditions. Given this fact, the issue of timely diagnosis and treatment of diseases of the female genital organs is a priority for preserving the population.

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Epidemiology

The prevalence of diseases of the female reproductive organs ranks first among all diseases in women of childbearing age.

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Causes cervical condylomas

Causes of cervical condyloma are viral particles that get on the mucous membrane of the female genital organs. There are more than a hundred types of human papillomavirus. The main feature of some types is oncogenicity - the ability of the virus 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 route of transmission of the virus is contact, in this case, sexual. But infection with the virus may not always lead to the development of the disease, this is due to the characteristics of the female genital organs. The secretion that is secreted by the glands of the vagina has a slightly acidic environment, which is destructive for many viruses and bacteria. The human papilloma virus is a DNA-capacious virus that has a reliable protein shell with a good protective mechanism. These properties help the virus to enter the epithelial cells and live there for a long time. At a convenient moment, when the concentration of local immune mechanisms decreases, the virus begins to actively multiply. Therefore, the causes of cervical condyloma 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 condyloma is quite simple and is based on the defeat of the epithelial cell by the virus. The papilloma virus gets on the mucous membrane of the female genital organs by contact. After that, the viral particle penetrates the epithelial cell. But this may 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 other cases, the disease may manifest itself immediately. When the virus penetrates a cell, it penetrates the cell nucleus and destroys the structure of the cellular DNA. Instead of the DNA of a normal epithelial cell, the virus inserts its own DNA. This happens to many neighboring cells. As a result of this process, the cell begins to function incorrectly and unprogrammed cell division begins. All these cells grow, hyperplasia occurs, and characteristic condylomas appear. These cells can be of different sizes, depending on the number of cells affected by the virus. Since this is a benign process, the condyloma does not penetrate the basement membrane, but grows only into the lumen. The size of the condyloma depends on the number of cells formed.

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Symptoms cervical condylomas

According to the type of predominant cellular elements and the nature of morphological changes, flat and pointed condylomas of the cervix are distinguished. Symptoms of cervical condylomas, depending on the type, differ to some extent. In most cases, the disease proceeds without visible symptoms. This is explained by the localization of the process, which cannot be determined with the naked eye. Symptoms may appear when a woman becomes pregnant, and then serious problems arise. But as the condylomas grow, they can cause symptoms.

The main symptoms of cervical condyloma:

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

The first signs of cervical condyloma appear if the process has reached significant sizes. Most often, everything begins with a small bleeding when the condyloma is injured. This can happen after sexual intercourse. The process of sexual intercourse itself can also cause discomfort and unpleasant sensations. If such symptoms appear, you need to see a doctor.

Women often come with a fairly common problem - infertility. One of the reasons may also be a condyloma of the cervix, which prevents the normal passage of sperm.

Symptoms of cervical condyloma may also first appear during childbirth. Then an obstruction occurs and the baby cannot pass through the birth canal normally, or the condyloma itself is injured and causes bleeding. The baby may also become infected with the virus while passing through the birth canal.

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Forms

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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 a 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 the deep layers of the epithelium. Atypical cells that form when infected with the virus are very difficult to identify. They do not rise above the surface of the epithelium, unlike pointed ones, do not have any characteristic color and are often small in size. There is evidence that only a flat condyloma can have symptoms in the form of pain, burning, itching, due to deep penetration into the epithelium to nerve cells. All this is dangerous due to late detection and untimely treatment. Flat condyloma of the cervix often becomes malignant. This is even more dangerous. With a simple examination, such a condyloma is extremely difficult to detect, so additional methods are used. The mucous membrane is stained with Lugol's solution or acetic acid solution, then the area with the condyloma looks colorless against the background of the stained surrounding epithelial cells. To confirm the etiology of the condyloma, a biopsy is mandatory.

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Pointed condyloma of the cervix

Unlike flat condylomas, pointed condylomas of the cervix indicate an acute viral process. They usually appear suddenly and look like growths on a short stalk in the form of seaweed. Pointed condylomas are located as single formations or as grouped clusters. On the epithelium, they often have a pale pink color. These growths are injured and cause the symptoms listed above. A characteristic symptom of such condylomas is itching and burning in the genital area, and if the integrity of the epithelium is damaged, bleeding may occur. In terms of diagnostics, pointed condylomas are clearly visible during examination, which increases the number of detections of this type of condylomas. During a gynecological examination, they have a characteristic appearance, grow into the lumen of the organ, and can be located in a group or be single. Pointed condylomas are superficial, because the virus multiplies in the upper layers of the epithelium. In terms of treatment, these condylomas are more favorable and respond better to treatment due to exophytic growth. It should also be noted that in the absence of adequate and timely treatment, pointed condylomas tend to spread. At the same time, similar changes quickly appear in neighboring areas, and condylomas may subsequently be on the mucous membranes of the vulva or external genitalia.

Condylomas on the cervix

Condylomas on the cervix are a very common, but at the same time dangerous localization. According to localization, condylomas are distinguished on the vulva, in the vagina, on the cervix, on the labia. Of all the options, condylomas on the cervix are the most unfavorable. With this localization, it is very difficult to diagnose them and therefore they are detected at late stages. This localization is dangerous in terms of malignancy, and can also be the cause of disruption 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 significant sizes, and their instability in terms of the development of oncopathology increases. Condylomas of the cervix can cause female infertility, because it is the cervix that allows a certain number of spermatozoa to pass, and with a condyloma, an obstacle to normal sexual intercourse arises.

Often this reason is not taken into account, although it may well be the only one. The virus is still in the cells it has affected and may infect the fetus in the future if pregnancy has occurred. Condylomas located on the cervix are, in most cases, flat in structure, 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 for examination and treatment.

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Complications and consequences

As is known, cervical condyloma is not as dangerous in its course as it is in its consequences. The human papilloma virus, which is the etiological factor of condyloma, is very dangerous. It does not always lead to the manifestation of symptoms after infection, but can simply sit inside the cell and wait for a convenient moment to activate the process of cell division. That is why this virus is dangerous. It is unknown how the cell will behave with such a restructuring 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 the condyloma, the probability of malignancy varies. If the pathogen is an oncogenic type of virus, then the probability of oncological degeneration is high. Therefore, one of the most serious complications is the transformation of condyloma into cervical cancer. A higher percentage of malignancy occurs with flat cervical condyloma, because this is a deeper process.

The consequences and complications of cervical condyloma are not only cancerous degeneration. There are other possible complications: bleeding when the condyloma is injured, complications during childbirth, and disruption of the ovariomenstrual function. If the integrity of the condyloma is damaged and it becomes infected with bacterial flora, an infectious process may develop.

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Diagnostics cervical condylomas

Diagnosis of cervical condyloma must be complete and comprehensive to select the correct treatment.

When any symptoms of female genital diseases appear, it is necessary to consult a specialist. Anamnesis data helps to establish the possible nature of the process, the source of infection, possible other bacterial infections, the degree of impairment of the patient's general condition.

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

After examination and if there is a suspicion of cervical condyloma, the doctor conducts instrumental and laboratory tests.

The tests that need to be taken are a general blood and urine test, a vaginal smear. A biopsy of the condyloma is mandatory, or after its surgical removal it is sent for a morphological examination. This analysis indicates what cells are in the biopsy, the degree of their dysplasia, the depth of invasion, and also confirms the benign nature of the formation. From the biopsy, if the virus is found in the cells, it is necessary to determine what type of human papillomavirus is the causative agent in a particular case (we are afraid of oncogenicity). Determination of the type of virus can be done by the polymerase chain reaction method, but determining the type is very difficult.

Among the instrumental diagnostic methods, colposcopy is used. This method makes it possible to see the mucous membrane of the cervix with illumination at a magnification of tens of times, changes in the mucous membrane are clearly visible. A biopsy of the necessary area can be taken immediately.

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Treatment cervical condylomas

Treatment of cervical condyloma depends on the type - pointed or flat condyloma - the size of the condyloma, the woman's age, the severity of symptoms. Considering the fact that the human papilloma virus is associated with the development of cervical cancer in women, condyloma must be treated in any case. Self-healing or involution of condyloma does not happen.

The regimen is general, since the general condition is not disturbed. It is recommended to limit sexual intercourse before and during treatment to prevent injury to condylomas.

The diet is unremarkable.

There are medicinal treatments, surgical and folk remedies.

Drug treatment is used for small sizes and initial manifestations. Since the pathogen is a virus, parenteral antiviral agents and immunoglobulins are used. But there is no antiviral drug with proven action against this virus, so this treatment is non-specific. Drugs such as Genferon and Panavir are used, which stop the reproduction of the virus and have an immunomodulatory effect.

It is possible to use medications for external use - the drug "podophyllin" is smeared on the condylomas once a day and the number of cells decreases slightly. Medicinal cauterization with 10% trichloroacetic acid is also possible. This treatment is used once a week and repeated until the cell mass decreases. There is another specialized drug for cauterization - "Solkovagin". It has no toxic effect on the surrounding healthy epithelium.

It should be remembered that long-term conservative treatment is inappropriate if it does not bring results, because with each slowdown the percentage of possible malignancy increases.

Folk treatment of cervical condyloma

The prevalence of the pathology and the seriousness of the problem forced people to look for folk methods of treatment. Today, folk treatment of cervical condyloma includes the use of homeopathic remedies, herbal treatment and home remedies.

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

Among other folk remedies, the following methods are used:

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

Herbal treatment also proves its effectiveness. Basic recipes:

1. Plantain leaf, horsetail, nettle and lemon balm leaves, dandelion root should be poured with one liter of water and boiled. After this, the decoction should be infused for 3-4 hours and taken in the morning before meals, one teaspoon.
2. Hop cones, valerian, linden, coriander, motherwort and oregano should be poured with a liter of hot water and after it has steeped, drink 2 teaspoons in the morning and evening.
3. Oregano herb, birch buds, St. John's wort leaves, calendula, chamomile, celandine, linden and succession are poured with boiling water, infused and drunk half a glass 4 times a day.

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

Immuntil suppositories are recommended to increase local immune protection and prevent virus activation.

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Surgical treatment of cervical condyloma

Surgical treatment is used if long-term conservative treatment has not yielded results. Then there is no point in delaying, because complications of the disease are possible. Sometimes surgical treatment of cervical condyloma is used immediately. This happens with a large volume of condyloma, with pronounced clinical manifestations or when complications are detected. In most cases, although this is an invasive method, it is very effective, because atypical cells are completely removed.

Among the surgical methods used are cryodestruction, cauterization with liquid nitrogen, laser cauterization, and removal of condyloma.

Condyloma removal is convenient if the condyloma has a well-defined stalk and can be easily removed. Then the condyloma is sent for histological examination, where the type and nature of tissue dysplasia are determined. Flat condylomas are inaccessible to simple removal, so other methods of treatment are used for them.

Condyloma cauterization can be performed using cryodestruction. Cold is used, which freezes the condyloma, and they fall off. This procedure is repeated 1-2 times a week until the condyloma completely disappears. Cauterization with liquid nitrogen works on the same principle.

Laser therapy, using a laser beam, can burn away warts like a scalpel.

Prevention

Considering the fact that cervical condyloma is associated with the development of cervical cancer, the issue of disease prevention is very relevant.

Among non-specific methods of prevention are elementary rules of personal hygiene, exclusion of promiscuous sexual intercourse, timely annual preventive examination at the antenatal clinic. You need to be attentive to your health.

Specific methods of prevention against certain viruses have been developed.

Today, vaccines against the human papilloma virus, some of its types, have been invented. One of the vaccines, "Gardasil", is used against types 6, 11, 16, 18. It consists of three doses that 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 condylomas, since infection can occur with another type of virus.

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Forecast

The prognosis for recovery and life of cervical condyloma is favorable. After all, it is a benign disease with non-invasive growth. Condylomas are easily treated, and are diagnosed well with timely early treatment.

Cervical condyloma is a pathology that is associated with the further development of cervical cancer. But this disease is not so scary if it is diagnosed in time and treatment is started. During a preventive examination, cervical condyloma can be detected and treatment can be started. Surgical treatment promotes complete recovery. You need to devote time to your health, and it is better to prevent diseases than to treat them later.

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