Human Papilloma Virus (HPV)
Condylona Acuminata
Genital warts are caused by the human Papilloma virus (HPV). They appear anytime from three weeks to three months after exposure to the virus. When visible on the vaginal lips and anus, they look the same as common skin warts.
Warts on hands and feet probably do not spread to the genitals. HPV is usually transmitted during sexual intercourse with an infected partner. It is very contagious. Using a condom may help prevent its spread.
On men, the warts usually occur on the scrotum, toward the tip of the penis, sometimes under the foreskin, and occasionally on the shaft of the penis.
In women the cervical lesions are the hardest to detect. They are usually flat making diagnosis difficult unless a pap smear or biopsy is obtained. Occasionally, the symptoms a woman notices are an increase in vaginal discharge or vaginal infections.
Diagnosis of condyloma is usually made by examination with a special microscope called a Colposcope. During a colposcopy, the genitals are swabbed with a vinegar solution turning the warts white.
In the past, warts were primarily a nuisance and not associated with serious medical complications. The changes detected by a Pap smear and/or colposcopy indicate women with HPV cervical lesions have a greater-than average risk of developing cancer.
Not all HPV's cause cancer. Of the 50 some varieties only about a dozen are linked to the disease. Testing can be performed for the type of virus, however, there is controversy as to the best way to implement this into the care of patient.
No medication is available to cure this virus. Doctors can destroy the cells where the virus lives with laser therapy, freezing or caustic chemicals. There are herbal remedies available, however, they have not been proven successful by scientific investigation. These methods help control the infection when its active. The virus may retreat into cells and hibernate for as long as 20 years. No matter what treatment you have, it may take multiple sessions to bring the infection under control. It is important they continue until the Pap smears produce normal results.
Sexual partners also should be treated to keep the virus from spreading.
TREATMENT TECHNIOUES FOR HPV WARTS
Warts are caused by a virus. A virus is a non-living piece of genetic material that cannot live outside a cell. Presently, the only way to destroy a virus is to destroy the cells within which the virus lives. All treatments for warts have this purpose. As the warts do not, as far as we know, invade deep into tissue, the purpose of wart treatments is to remove the superficial lining is burned, the lining peels, and it is then replaced with a new "clean" lining without any scarring.
LASER THERAPY
Laser therapy uses a highly charged stream of light to boil the water in the cells, causing them to burst. In this process both the cells and virus are destroyed.
PODOPHYLLIN
This is a resin made from plants which selectively destroys cells which contain virus.
It is applied with a cotton tipped applicator to small areas ON THE OUTSIDE ONLY. It also destroys a small amount of nor: al cells which causes some irritation. It should be washed off about six hours after application. This treatment often requires 1 to 5 applications over several weeks to remove the
TRICHLOROACETIC ACID
This is an acid which burns everything it comes in contact with. When applied TO THE OUTSIDE AREAS ONLY it burns through the wart and down into the normal skin. It causes intense burning when applied and creates shallow ulcers after treatment.
It should be washed off about six hours after application. It usually only requires 1 to 2 applications for removal of the warts.
CRYOSURGERY
Liquid Nitrogen may also be used to destroy the cells that harbor the HPV virus.
Tubal Coagulation
For women who are certain they do not and will not want to have more children, tubal ligation is an option for pregnancy prevention. Unlike other forms of birth control, most doctors believe it does not effect the menstrual cycle or the hormonal levels. The ligation of the tubes simply blocks the fallopian tubes from carrying the microscopic eggs needed for pregnancy from the ovaries to the uterus.
Tubal coagulation, the type of ligation commonly performed, is one of the safest and most effective methods of tubal closure. This is the procedure type which will be described below. The procedure is often performed on an out-patient basis.
Prior to the procedure there should be a consultation in the office. Any questions can be answered at that time. Partners are often invited, but their consent is not required.
The operative procedure lasts about 20 to 30 minutes and is performed under general anesthesia administered by an anesthesiologist. A small 1/2 inch incision is made in the bottom of the naval (belly-button). Carbon dioxide is then inserted through a small needle to hold the abdominal wall away from the internal organs. This allows a clear view of the tubes, ovaries and uterus.
After elevating the uterus with a small instrument, the doctor uses a telescope called a laparoscope to seal the fallopian tubes using electric cautery. After this the physician checks the ovaries, the uterus and the remainder of the abdomen to be sure there are no abnormalities. The gas is then forced out and the wound is closed with a stitch. A dressing is then applied. After healing, the incision is almost invisible.
After the procedure there will often be some discomfort in the shoulders due to the carbon dioxide used. There will also be some tenderness and itching in the incision. There may be some discomfort in the lower abdomen in the areas where the tubes were coagulated. The anesthesia may make you groggy for the evening. Work and normal activities may usually be resumed within two days.
Tubal coagulation is a form of permanent sterilization. It should only be considered if the women does not ever want to have children again. There are procedures to reverse the tubal ligation, however, they are only successful less than half the time and even less often when the tubes are electrically burned. In addition, tubal ligation does not always work. Sometimes women still get pregnant after having their tubes cauterized. The failure rate is usually quoted at about one women in three hundred. These women are also at higher risk for pregnancies in the tubes, which can be dangerous.
Other types of tubal ligation include closure by clips, rings, cutting, and tying. The route by which sterilization is achieved is determined by many factors, most of all the surgeons experience and familiarity with tubal ligation techniques.
Sexually Transmitted Disease
Sexually transmitted diseases (STDıs) are as of great importance as any contemporary issue. They affect all reproductive organisms, and can have ominous implications and manifestations.
It is of vital importance to be aware that most STDıs can be prevented by education, planning, and behavior modification.
There are literally thousands of different types of STDıs, however, only a small number are of importance in industrialized nations. These include:
1.HIV
2.HPV (Human Papilloma Virus)
3.HSV (Herpes)
4.Syphilis
5.Gonorrhea
6.Chlamydia
7.Hepatitis B
8.Molluscum Contagiosum
9.Scabies and Crabs
The best way of preventing STDıs is abstinence. Since this is not a reasonable alternative for most people, there are other options as well. Barrier contraceptives, such as the male and female condom help prevent the transfer of contagious organisms from bodily fluids. However, they are not perfect and do not always prevent some diseases such as HPV.
Some diseases such as gonorrhea and chlamydia can cause scarring on the internal organs such as the tubes and cause infertility and pain.
