A Guide to Male Genital Warts and its Treatment
Recently, there has been increased awareness of a previously “hidden” problem which has brought out publicly and now discussed more openly. Both men and women are now more conscious of genital warts or papilloma which may afflict them co-equally. It is considered to be one of the most common sexually transmitted diseases. Males that are at greatest risk for this disease are those who are in their 20’s are uncircumcised, had sexual intercourse at an early age, had multiple partners without adequate protection. There has been more males seeking consult and more women have been accompanying their male partners for a physician’s visit.
Human Papilloma Virus (HPV) are spread from one person to the next through direct skin contact. Majority of HPV infections particularly types 6 and 11 is passed on through unprotected sexual intercourse in up to 75% and may incubate or present to the patient within weeks to months. . Around 70% of female anal- genital and cervical cancers are a result from exposure to HPV types 16 and 18.
The disease is often associated with other sexually transmitted diseases such as gonorrheal and Chlamydial urethritis. Those who are infected with the Human Immunodeficiency Virus (HIV), the precursor of the dreaded AIDS may be concomitantly infected with HPV.
A majority of men unfortunately purposely delay consultation or treatment for common reasons such as personal embarrassment due to the disease’s social stigma. Often the disease maybe without symptoms or that the tiny lesions are just simply not yet visible until they have multiplied and have caused anal-genital disfigurement. Tragically, these are the reasons that promote the spread to their clueless partners or their significant other.
Papillomas are identified initially as small single or multiple brownish raised, soft irregular cauliflower-like lesions commonly found in the scrotum, anus and penis. In women it is seen in the outer genital labia, anus later spreading within the cervix and vagina. The lesions multiply then becomes confluent to converge into rows of irregular small masses in these affected areas. Genital disfigurement, scarring and complications such as cancerous degeneration occur when there is delayed or inadequate treatment. All these may be avoided through the patient’s self-examination in order for him to seek the specialist for confirmation and treatment, also to prevent disease transmission.
Diagnosis is only through direct physical examination and identified by their typical appearance typically identified through the following images as follows:
Current treatment for Human Papilloma Virus/genital or venereal warts:
The most straightforward technique of eliminating warts with the most consistent results in avoiding recurrence of the disease. This is an outpatient procedure which requires only a topical (skin) anesthetic involving the use of electrosurgical needlepoints to eliminate the wart. There is minimal scarring and no infection after the procedure
This technique involves freezing the genital warts with liquid nitrogen. This results in a blistering of the warts, which then ulcerates and later heals. Potential for infection of healing with painful ulcers exists. This is also common primary treatment for genital warts.
CO2 Laser Desiccation:
The use of laser thermal light energy to burn away genital HPV infection.
Chemical Medication treatment:
Podofilox topical gel. This resin is a plant extract that is toxic to the HPV infected cells. This treatment cannot be used in pregnancy. Must be used over the course of 4-6 weeks
This is not a cure, but the use of Imiquimod cream enhances the bodies natural immune reaction to fight the HPV infection.
Recurrences of up to 60% with papilloma regrowth however do occur and repeat treatment becomes necessary.
Sexual abstinence and involvement in a monogamous relationship are the only effective means to prevent disease transmission of HPV. Males who are circumcised and using adequate barrier protection during sexual intercourse may offer protection. Vaccination for females is used to stimulate the body’s immune system to produce neutralizing antibodies that protect the skin cells of the genitalia. Therefore they are not considered curative treatment but prevents the development of anal-genital and cervical cancer. Ideally it is given at the earliest age prior to onset of puberty and before first sexual contact. This has been established to provide adequate protection specifically for women. Similar beneficial effects for males have been proposed although these are presently unverified.