Genital Warts: Causes, Treatment, and Risks Explained

Regarding cauliflower?

Dear Dr.
Liu,
My girlfriend discovered several small, granular lesions at the vaginal opening during her visit to the gynecologist.
They are painless and itch-free, and the doctor diagnosed them as genital warts.
However, we are both monogamous partners and have never had this condition before, so we are unsure how she contracted it.
Why does she have these symptoms while I do not? Isn't this condition transmitted through contact?
I have a few questions regarding this condition and hope you can provide some answers.
Thank you!
1.
Can this condition have a latent period of several years before manifesting now? Is it possible to completely eradicate it? Will it recur in the future?
2.
What is the most effective treatment method currently available? What is the cost?
3.
Since there is a high incidence of cervical cancer among patients with this condition, does having genital warts significantly increase the risk of developing cervical cancer? What is the percentage? Are there any preventive measures?
4.
I have heard that this virus can sometimes be transmitted through touching contaminated objects with fingers and then touching the vaginal mucosa, leading to infection.
Is it true that the virus may not manifest when the immune system is strong but may become active when the immune system is weakened? How long does the treatment take?
Thank you!

pp, 20~29 year old female. Ask Date: 2001/06/11

Dr. Liu Jianting reply Urology

Having genital warts can indeed be concerning.
However, the presence of small, granular lesions at the vaginal opening may not necessarily indicate genital warts; they could also be benign papillomatous growths or other normal variations.
Even experienced physicians may require a biopsy for a definitive diagnosis, as genital warts, known as condylomata acuminata, are a sensitive and troubling issue.
If it is indeed genital warts, they are caused by a sexually transmitted viral infection that can remain dormant for a period before becoming apparent.
Typically, they affect the mucosal tissue of the genital area, and even after treatment, there is a possibility of recurrence.
Additionally, cervical cancer in women has been confirmed to be associated with HPV infection.
Therefore, practicing "safe sex" is crucial to avoid potential harm.
It is advisable to visit the Department of Health's website for more related information.

Reply Date: 2001/06/11

More Info

Genital warts, also known as condylomata acuminata, are caused by certain strains of the human papillomavirus (HPV), particularly types 6 and 11. These warts appear as small, flesh-colored or gray growths in the genital area and can be painless and asymptomatic, which often leads to delayed diagnosis. Your girlfriend's diagnosis of genital warts, despite both of you being in a monogamous relationship, raises important questions about the nature of HPV transmission and the behavior of the virus.

Understanding HPV Transmission
HPV is primarily transmitted through skin-to-skin contact during sexual activity, including vaginal, anal, and oral sex. However, it is important to note that HPV can remain dormant in the body for years without causing any symptoms. This means that either partner could have been exposed to the virus in the past, even before the current relationship began. It is also possible for one partner to have the virus and not show any symptoms, while the other partner develops warts.

Latency and Recurrence
1. Latency Period: HPV can indeed have a latency period that lasts several years. It is not uncommon for the virus to remain inactive for a long time before symptoms appear. This can create confusion regarding when and how the infection was contracted.

2. Complete Eradication: While there is no cure for HPV itself, many individuals with genital warts can have them treated effectively. Treatment can remove the warts, but the virus may still remain in the body. This means that while the visible symptoms can be managed, the potential for recurrence exists.
3. Recurrence: Recurrences of genital warts can happen, especially if the immune system is compromised. Factors that can weaken the immune system include stress, illness, or other infections.

Treatment Options
The most effective treatment for genital warts varies depending on the size, number, and location of the warts. Common treatment options include:
- Topical Treatments: Prescription creams such as imiquimod (Aldara) or podofilox (Condylox) can be applied directly to the warts.

- Cryotherapy: This involves freezing the warts with liquid nitrogen, which can be effective but may require multiple sessions.

- Electrosurgery: This method uses electrical currents to remove warts.

- Surgical Removal: In some cases, warts may need to be surgically excised.

The cost of treatment can vary widely based on the method used and the healthcare provider. It is advisable to consult with a healthcare professional for specific pricing and treatment plans.

HPV and Cervical Cancer
Regarding the association between genital warts and cervical cancer, it is important to clarify that while HPV types 6 and 11 are responsible for genital warts, they are not the same strains that cause cervical cancer. The high-risk HPV types, particularly types 16 and 18, are more commonly associated with cervical cancer. However, individuals with genital warts may still be at risk for other HPV-related complications, and regular cervical screenings (Pap smears) are recommended for early detection of any abnormalities.

Prevention
To reduce the risk of HPV transmission and the development of genital warts, vaccination is highly recommended. The HPV vaccine can protect against the most common high-risk and low-risk HPV types. Additionally, practicing safe sex, such as using condoms, can lower the risk of transmission, although it does not eliminate it entirely due to the possibility of skin-to-skin contact.

Conclusion
In summary, genital warts are a common sexually transmitted infection caused by HPV. They can remain dormant for years, leading to confusion about their origin. While treatment options are available to manage and remove warts, the virus may persist in the body, leading to potential recurrences. Regular medical check-ups and HPV vaccinations are crucial for prevention and early detection of related health issues. If you have further questions or concerns, it is best to consult with a healthcare provider who can provide personalized advice and treatment options.

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