Health

Condylomas are ano-genital warts caused by a virus belonging to the papillomavirus (HPV) group. Some papillomaviruses can cause cancer, particularly cervical cancer.

WHAT ARE THE CAUSES?

Condylomas are sexually transmitted, but many years can pass between the time of contamination and the appearance of the first ano-genital warts. It is therefore difficult to know when contamination occurred. Condylomas appear mainly in people with multiple partners, during unprotected sex and when the immune system is weakened.

HOW DO CONDYLOMAS DEVELOP?

After unprotected, high-risk sexual intercourse, the papillomavirus can set in without the condyloma developing immediately. It can take several weeks or months for it to appear. Transmission is not systematic. One partner can be infected without the other being infected.

HOW ARE CONDYLOMAS DISCOVERED?

Condylomas are painless and the color of the skin. They can be single or multiple, small or large, raised or in the form of spots. They appear as small growths or soft warts, called "acuminate condylomas". These warts, often multiple, are located throughout the anogenital sphere (anus and genitals), in both men and women. These condylomas are benign, but often recur after treatment. Some of these condylomas are not visible to the naked eye, in which case they are called "flat condylomas". They are often located on the glans and urinary orifice or on the cervix and vagina. These lesions can go unnoticed and, over the years, worsen into precancerous lesions, then cancerous, hence the importance of having cervical smears.

HOW IS THE DIAGNOSIS CONFIRMED?

If lesions are discovered in the anal and/or genital region, and for both sexes, an anoscopy is systematically performed. This examination is carried out with an anoscope, a type of speculum that is inserted into the anus, and which allows the doctor to examine the mucous membrane of the anal canal and the lower rectum.

In women: a complete gynecological examination will be carried out, including an examination of the cervix, called a colposcopy. A smear will always be necessary. In men: after a complete genital examination, an endoscopic examination of the urethra may possibly be carried out by a urologist.

WHAT ARE THE ACTIONS TO TAKE AFTER THE DIAGNOSIS?

Condylomas due to HPV are sexually transmitted diseases. If you are a carrier of this virus, it is essential to inform your partner so that he or she can also carry out the screening test. Using a condom will prevent your partner from becoming infected.

As this is a sexually transmitted infection, other screening tests are necessary (HIV, syphilis, hepatitis B and C). In addition, HPV serotyping may be carried out to determine the strain of the virus in question.

WHAT IS THE DEVELOPMENT?

Treatments are long and recurrences are frequent. Most condylomas have a benign development, but some unnoticed cervical or anal condylomas can worsen and degenerate into cancerous lesions.

In order to ensure that there is no recurrence, or to allow it to be treated early, your doctor may offer you a monthly consultation as long as there are visible lesions, then three, six and twelve months later if the clinical examination does not find any lesions.

WHAT ARE THE TREATMENTS?

It is essential to treat all sexual partners with condylomas simultaneously. These treatments are essential because they will destroy the condylomas and, therefore, the quantity of virus present in the body. These are local treatments:

• Medicinal in the form of cream or ointment.
• Cryotherapy (liquid nitrogen).
• Electrocoagulation.
• Laser.
• Surgery.

Treatment of condylomas must be followed by prolonged monitoring, in order to detect recurrences and treat them early.

ARE THERE ANY MEANS OF PREVENTION?

Some condylomas can be prevented by vaccination. The vaccine used provides immunization against 6 to 9 HPV subtypes, depending on the vaccine used, including two responsible for genital warts: HPV 6 and HPV 11. Vaccination is recommended and reimbursed before the start of sexual activity for all girls aged 11 to 14 according to a two- or three-dose schedule and as a catch-up for girls aged 15 to 19. It is also recommended for men who have sex with men, aged 14 to 19, with a possible catch-up up to the age of 26.

As with any sexually transmitted disease, the use of condoms remains the only way to avoid contamination during risky sex or in the case of multiple partners.