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Genital warts
These
tiny growths, which appear around the genitals, are caused by the
human
papilloma virus (HPV), which is also the same family of warts that
is responsible for skin and plantar warts on the feet. Genital warts,
however,
are not so benign—they are three times more common than herpes
and highly contagious. Some strains have been associated with cervical
cancer in the female.
Genital warts are believed to be quite common, although many of them
escape detection if they are within the vagina or present in a non-visible
form on the penis. Immediate treatment by removal of the warts with
surgery or topical preparations is recommended, but the virus may return.
How to avoid the sexually transmitted disease
that condoms may not prevent
Among male health problems, genital warts ranks first on a number of
counts: It's the most common reason a man comes to my office. It's
one
of the easiest sexually transmitted diseases to get; at least 12 million
people have it. Visits to health professionals for genital warts have
increased 1,000 percent since 1986; there as many as 1 million new
cases
each year.
Genital warts actually describes a group of viruses called human papilloma
viruses (HPVs). There are more than 60 different strains. Some cause
visible flat or cauliflower-like warts, called condyloma acumata; others
are not visible without special means. Unfortunately, the obvious warts
aren't the most dangerous form of HPV.
Several strains of HPV have been linked to cervical cancer in women
and penile cancer in men. In fact, the virus is found in virtually every
sample of cancerous material removed from the genitals of men or women.
Because the most dangerous strains don't produce symptoms, many men
who have HPV don't find out until their partner's Pap smear shows an
abnormality. The discovery almost inevitably throws the relationship
into turmoil, and it begins what may be a long, uncomfortable, and frustrating
set of treatments.
First comes diagnosis. For invisible warts, we wrap the penis in cloth
saturated with a mild vinegar or acid solution, wait five minutes, and
look with a microscope. The condyloma will be stained white. Further
testing to determine the strain of HPV is possible but impractical.
It's very expensive and doesn't affect how we treat the problem.
At present, we can't cure condyloma, but we can eliminate visible signs
of it. Warts can be removed with caustic solutions, creams, injections,
freezing, burning, or lasers. Although they may return at any time—depending
on a variety of poorly understood factors—removing warts may
reduce cancer risk.
If you're getting the impression that genital warts are something you
really don't want, you're getting the right idea. But avoiding them
may not be as easy as you think. Because condyloma can infect areas
of skin not just on the genitals but also near them, condoms are not
necessarily effective prevention. Even in relationships where an infected
partner always wears one, the other partner develops HPV in 65 to 75
percent of all cases.
Only abstinence, long-standing monogamy, or very careful selection of
a partner can protect you from HPV. Don't assume it won't happen to
you.
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