Removal of genital warts

In modern dermatological, proctological and gynecological practice, the removal of genital warts is considered to be the most effective method of getting rid of the apparent manifestation of human papillomavirus infection in the squamous epithelium of the skin and mucous membranes of the anal and urogenital area.

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Indications for the removal of genital warts

Typical localization of viral condylomatosis in women - external genitalia, vagina, cervix, urethral opening, perineum, external and internal surfaces of the anus; in male patients, genital genital warts occur on the foreskin and penis head, on the scrotum, near the opening of the urethra, in the urethra, around and inside the anus.

Indications for the removal of genital warts include factors such as:

• progression of pathology, in which the size of the condyloma increases or their number:
• the presence of large condylomas, which do not respond to local medication with ointments;
• permanent trauma to genital warts up to their bleeding;
• physical discomfort and problems with sex, urination, defecation;
• the threat of difficulties during the forthcoming birth (with localization on the cervix and cervical canal) and infection of the newborn;
• the emergence of psychological discomfort due to an external defect.

In addition, studies of the last decade have shown that in case of oncogenic types of the virus, papillomas 16 and 18 of condyloma on the cervix can lead to squamous cell carcinoma.

How is genital warts removed?

Removal of genital warts can be done:

• surgically (excising),
• hardware ablation (diathermocoagulation, cryogenic destruction, laser coagulation, radio wave excision),
• contact chemical method.

Classical surgical excision of genital warts is applicable for single sufficiently solid formations (diameter 10 mm or more) formed on the penis, in the vagina or around the anus, for extensive formations, and also in relapses of condylomatosis after other methods of treatment. Excision is performed under local anesthesia, the wound is replaced with sutures on the site of excised condyloma, then a scar is formed. Soreness after the operation can last up to three weeks.

Removal of genital warts by electric current - diathermocoagulation: it is the burning out of formation by the high temperature created by the current of high frequency. The method is painful, so local anesthesia is needed. In place of the scorched genital wart, a scab is formed, which independently disappears after 7-8 days. After the descent of the scab remains a large scar. At present, electrocoagulation is considered an outdated method; according to foreign experts, the probability of recurrence after its application ranges from 30 to 70%.

Nitrogen removal

Cryotherapy or removal of genital warts with nitrogen is the destruction of the condyloma by instantaneous (for 10-20 seconds) tissue freezing with liquid nitrogen (temperature below -195 ° C). There is necrosis and rejection of condyloma. This method is most often used to remove several small condylomas, especially those located on the penis, in the vagina, rectum and urethra. Although there is an opinion that this method should not be used in hard-to-reach places.

Local anesthesia is used if there are warts in several places or when there is a significant lesion area.

During the procedure, patients feel a burning sensation, and after its completion - a moderate pain. Blisters, hyperemia of the skin may appear, but scarring practically does not remain. Healing occurs on average for two weeks. The probability of recurrence of pathology (after several months) is 20-40%.

Laser Removal

Laser therapy (with the use of carbon dioxide or infrared lasers) completely removes viral neoplasm with an efficiency of up to 90%. But this method is very painful and is performed under local anesthesia or general anesthesia - depending on the number and size of the warts. As a rule, wounds heal for at least a month, at the site of removal there are scars.

The removal of genital warts by the laser is recommended for the treatment of large genital warts that can not be treated using other methods of physical ablation due to access difficulties. This refers to genital warts located deep inside the anus or urethra. With this method, the risk of recurrence of genital warts is 25-50%.

Radio wave removal

With this method, warts are removed using a special surgical surgeon Surgitron Dual, which acts without contact with tissues - radio waves. According to doctors and patients, this procedure passes quickly, minimally injures the surface of the skin and mucous membranes and does not cause pain.

Radio wave excision - the removal of genital warts by the radio wave method - refers to bloodless high-precision methods of apparatus surgery, because simultaneously coagulated dissected tissues, preventing bleeding. After its carrying out it is not necessary to impose seams and scars are not formed.

In general, experts believe that physical ablation is more effective in horny condylomata, and for soft genital warts in the genital area the contact chemical method of removal is more appropriate.

Solkoderm Removal

The chemical method of solving the problem is the removal of genital warts by Solcoderm. This solution (in ampoules of 0.2 ml) is intended for external use only. It consists of nitric, acetic and lactic acid, oxalic acid dihydrate and copper nitrate trihydrate.

The action of the concentrated acid compound leads to chemical denaturation of the proteins of the warts tissue, its drying out and falling away in the form of a scab. If the product gets on a healthy skin or mucous membrane, there is also a burn and necrosis. Therefore, according to the instructions, Solkoderm should be applied only in a medical institution, and the patient himself is not recommended to do this, although an applicator and a glass tube for manipulation are attached to the ampoules.

It should be borne in mind that the removal of genital warts at home is very problematic in the absence of a review of genital education, and it is also very unsafe if there are several of them and they are on mucous membranes. And doctors warn that attempts to get rid of genital by themselves can lead to their quantitative growth.

If the condylomatosis is multiple, then Solkoderm is not applied immediately to all formations, but in stages: 4-5 warts per procedure, 24-25 days later. In addition, after contact with water, it is necessary to conduct skin treatment in the area of application of the preparation with 70% medical alcohol. And in no case can not tear off the formed scab: he must fall away himself.

Preparations for the chemical removal of genital warts also include solutions of feresol (phenol with tricrezole) and Verruacid (phenol with meta-cresol), which should be applied only to the outside of the condyloma - several times, after the already applied solution has dried.

Complications after genital warts removal

The most frequent complications after the removal of genital warts are pain, swelling and redness of the tissues, discharge (with internal condyloma), bloody discharge (in case of blood vessel damage), erosion, inflammation (with infection). In addition, all methods of removal have a significant level of recurrence of the disease.

It should also be remembered that the removal of genital warts can not cure the human papilloma virus, which continues to remain in the skin and mucous in an inactive state, and the person can still spread the infection by contact and sexually.

[2], [3], [4], [5]