Complications of Untreated Genital Warts

And so you thought that the bump will just disappear…

Warts are caused by the Human Papilloma Virus or HPV which has 100 known strains. From these, around 40 types cause genital warts. Genital warts can be transmitted through vaginal, oral and anal sex, as well as through indirect contact, such as using the personal belongings of an infected person. An infected pregnant woman can easily transmit the virus to the baby either through an ascending or a descending route.

Around 50% of individuals with genital warts are oblivious to the infection, due to the fact that most of the time, the site of infection is deep within their vagina or urethra. Also, most often, genital warts spontaneously resolve even without treatment that most people are unaware that they had an HPV infection.

Genital warts usually do not appear until after several weeks after the viral entry to the host cells. Signs and symptoms may develop between one to four months after the exposure. In some cases, it can take up a year before any of the warts develop. They are usually painless but can be irritating with contact. The warts can be soft, flat or irregularly shaped. They can also be variable in color. Some are visibly red, and others could either be gray or pink. The more important thing is that any change in the appearance of the genital warts should alert the infected person on the possibility of malignancy.

Many treatment modalities are available to treat genital warts. Management options include self-administered solutions, such as the use of vinegar. Laser removal and cryotherapy are just among the myriad options that a gynecologist can offer to an infected person.

However, when warts are left unattended or did not resolve by themselves, they can either remain as it is or clump together forming a large cauliflower-shaped lesion. With these signs, the possibility of malignancy increases. Remember that the Human Papilloma Virus types 16, 18, 31, 33 and 35 are strongly associated with the development of cervical and rectal cancers. Of the small percentage who develops cancer, progression can take anywhere from 5 to 30 years. With this in mind, women should have their regular cervical pap smear. A result of cervical dysplasia on a routine cervical pap smear should alert a woman on the potential risk of cancer and should immediately consult a doctor. Remember that pre-cancerous cervical lesions are readily treatable.

Genital warts may ulcerate or may become infected, causing extreme irritation and discomfort. This is especially felt once the infection affects certain areas, such as the urethra, anus, rectum or the mouth.

Solutions such as podophyllatoxin are contraindicated to pregnant women since the drug has been proven to be teratogenic to the fetus. Because of this, it is very important to talk to your doctor about the different treatment options that would be safe not only for the mother, but also to the baby.

During the course of pregnancy, the warts could increase their size, making urinating difficult for a woman. Also, if the warts are on the vaginal canal, passage of the baby during birth could predispose the newborn to develop laryngeal papillomatosis (warts in the throat) that can cause respiratory distress or even death. Treatment involves surgery to unblock the obstructed airway.

Some genital warts are almost undetectable, particularly if they are flat and slow growing. With these, having a regular gynecologic check-up and practicing safe sex are the most important tools a woman should have to avoid genital warts, which are the culprits behind cervical cancer. Bear in mind that genital warts are readily treated if they are small and are few in number.

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