Genital Warts - Assignment Example

Genital Warts According to the National Institutes of Health, the sexually transmitted disease – genital warts – occurs in five and a half million people every year (“HPV Statistics”). Therefore, an insight towards its causes, appearance, risk factors, complications, treatment modalities and recent developments may give one an idea about how to deal with the disease better and more efficiently. The virus that causes genital warts is the human papillomavirus or HPV, although not all types of HPV can cause genital warts (Zieve, NIH). Type 16 HPV is responsible for around 50% of all cases of genital warts while Types 16, 18, 30 and 45 account for almost 80% of all cases (“Genital Warts”). According to Genitalwart-s.com, a site managed by the Genital Warts Support Team and whose content is obviously taken from reputable medical sources, genital warts are transmitted mainly through sexual intercourse with a carrier, whether this is vaginal, oral or anal sex. In fact, the possibility of acquiring genital warts from having sex with a carrier accounts for 66% of all cases. However, based on recent medical research, there is no evidence yet that genital warts are transmitted through contaminated medical equipment or even personal items like toothbrush and bath towels. According to the National Institutes of Health, among the factors that increase risk of genital wart infection include having multiple sexual partners, not knowing the sexual history or status of one’s partner at the time of intercourse, being sexually active at a relatively early age, using tobacco or alcohol, having another viral infection like herpes at the time of intercourse, being pregnant or having a weakened immune system that is attributed to a current illness or medication (Zieve, NIH). Other risk factors would include having acquired sexually transmitted infections or diseases in the past, and the use of oral contraceptives and birth control pills instead of condoms and other forms of barrier methods or mechanical prophylaxis, because the former would simply allow unprotected sexual intercourse to take place (“Genital Warts”). Nevertheless, male and female condoms would often prove to be poor ways of preventing genital warts because the HPV can be on the skin (Zieve, NIH). Additional risk factors, according to Genitalwart-s.com, include excessive stress, an experience of trauma such as one from a previous surgery, a serious illness, or a serious treatment for diseases such as cervical cancer (“Genital Warts”). Perhaps, another risk factor for genital warts but one which increases the risk indirectly is the lack of knowledge and information on the disease, which can be attributed to a lack of counseling experience. Counseling teaches individuals that “genital HPV infection is very common” and should therefore be avoided (“Sexually Transmitted,” CDC). According to data from the National Institutes of Health, genital warts may actually appear so tiny that they may not be seen at all. However, they are usually raised or flattened flesh-colored spots that may look like the “top of a cauliflower” (Zieve, NIH). Furthermore, genital warts are usually “flat, papular, or pedunculated growths on the genital mucosa” (“Sexually Transmitted,” CDC). Genital warts that are “papular” actually appear like small round raised bumps on the skin that appear like pimples, while “pedunculated” means that sometimes the warts may have a stalk that supports them while their top would look like a cauliflower. Actually, according to Genitalwart-s.com, genital warts start as small 2-millimeter-wide lesions but may later on grow wider in size, and, in women, may develop inside or outside the vagina or both, in the cervix or uterus, or externally around the anus. In men, the warts are located on the scrotum, the shaft, or the area around the anus as well. Moreover, in both sexes, the mouth and throat of both sexes may be affected if HPV is transmitted through oral sex (“Genital Warts”). According to data from the National Institutes of Health, these flat, papular or pedunculated warts may even cause cancer of the vulva and cervix as one of its complications. In fact, the NIH considers genital warts “the main cause of cervical cancer” (Zieve, NIH). However, according to the Centers for Disease Control and Prevention or CDC, “No evidence indicates that the presence of genital warts of their treatment is associated with the development of cervical cancer” (“Sexually Transmitted,” CDC). Thus, there seems to be some sort of disagreement between the NIH and CDC on the possible link between genital warts and breast cancer. Nevertheless, according to CDC, certain types of HPV can cause 70% of all cases of cervical cancers without having to produce genital warts first (“Sexually Transmitted,” CDC). Moreover, complications arising from treatment may include pain syndromes, painful defecation or other severe systemic effects (“Sexually Transmitted,” CDC). After having considered the nature of genital warts as well as the complications that they can bring about if not treated early or well, it is not time to discuss the various modes of treatment. According to a 2011 clinical study by the OBG Management, treatment modality for genital warts would normally depend on “the number and size of warts, the anatomic site of the warts, wart morphology, treatment costs, effectiveness, side effects, and convenience; patient preference; and provider experience with various therapies” (Cox et al.). This somehow gives one a picture of a slightly complicated mode of treatment for genital warts. Nevertheless, all these aforementioned aspects of treatment must be carefully considered to ensure overall success. Treatment for genital warts includes either cutaneous medication or surgical removal. According to CDC, treatment for external genital warts that can be applied by the patient may be Podofilox 0.5% solution or gel, Imiquimod 5% cream, or Sinecatechins 15% ointment. The provider can also administer cryotherapy using liquid nitrogen or cryoprobe every 1 to 2 weeks, podophyllin resin 10% to 25% tincture, trichloroacetic acid or TCA, Bichloroacetic acid or BCA 80% to 90%, or surgical removal through tangential scissor excision, curettage, tangential shave excision, or electrosurgery (“Sexually Transmitted,” CDC). Based on pharmacological data from CDC, the drug Podofilox can be applied with a cotton swab or a finger and the solution destroys warts. Podofilox is relatively more inexpensive than other treatments. Imiquimod, on the other hand, is a drug that stimulates the production of cytokines and interferons, which strengthen the immune system against the genital warts. The cream is usually applied three times a week for 16 weeks. The Sinecatechin 15% ointment is a green tea extract with an active ingredient known as catechin, which helps eliminate genital warts. It must be applied on the area for 16 weeks. Another type of medicine, the Pedophyllin resin 10%-25% has the same effect and is applied to the warts in the same way as Sinecatechin 15%. TCA and BCA are actually caustic agents that effect the chemical coagulation of wart proteins to destroy the genital warts. Another type of treatment, cryotherapy is used to “freeze warts at the cellular level” employs “thermal-induced cytolysis” using liquid nitrogen in order to destroy the warts. One more mode of treatment is surgical therapy, which gives the patient a chance to have his warts removed in just one visit. There is, however, a need for technical know-how on the part of the medical professional, as well as longer visits and good equipment. Lastly, physicians may use combination therapy or using two or more modes of treatment simultaneously in order to produce better and faster results (“Sexually Transmitted,” CDC; “Genital Warts”). While external genital warts may be treated with the aforementioned modalities, vaginal warts may use cryotherapy, Podophyllin, TCA or BCA, or surgical removal (“Sexually Transmitted,” CDC). Lastly, a huge part of post-treatment procedures for the removal of genital warts is counseling. During this time, fear and guilt are removed from the patient’s mind, and that the appropriate treatment methods may be introduced as well as tips on how to prevent infection (“Sexually Transmitted,” CDC). According to the research study conducted by OBG Management, one recently-developed treatment for genital warts is sinecatechins 15% ointment, which is sold under the brand name VEREGEN. This topical ointment can only be applied to patients who are 18 years of age or older. However, side effects would include redness, swelling, itchiness, pain and discomfort, as well as edema, ulcerations or rashes (Cox et al.). Another recent advancement in the treatment of genital warts, according to CDC, is the development of two HPV vaccines. These vaccines, which protect the individual against the HPV that causes genital warts and cervical cancers, must be administered before an age where there is any possible sexual contact or sexual intercourse. The two newly developed vaccines can be used on girls and women aged 11 to 26. Another vaccine, the quadrivalent vaccine, can be used on males aged 9 to 26 years (“Sexually Transmitted,” CDC). Top of Form Bottom of Form Works Cited Cox, J. Thomas, Huh, Warner, Mayeaux, E. J., Randell, Michael & Taylor, Maida. “Choosing the Most Appropriate Treatment Modality for External Genital and Perianal Warts: Expert Panel Commentary on Incorporating CDC Treatment Guidelines Into Current Clinical Practice.” Dec 2011. OBG Management. 10 Mar 2012. “Genital Warts Overview. 2012. Genitalwart-s.com. 10 Mar 2012. “HPV Statistics.” 2011. Genital Warts Remedy. 9 Mar 2012. “Sexually Transmitted Diseases Treatment Guidelines.” 2011. Centers for Disease Control and Prevention. 9 Mar 2011. Zieve, David. “Genital Warts.” 2011. The National Institutes of Health-MedlinePlus. 9 Mar 2011. Read More