What are the other Names for this Condition? (Also known as/Synonyms)

• Acuminate Condyloma of Vagina
• Vaginal Condyloma Acuminatum
• Vaginal Wart

What is Condyloma Acuminatum of Vagina? (Definition/Background Information)

• Condyloma acuminatum is one of the most commonly transmitted sexual infections. The infection is transmitted from one individual to another through direct sexual contact including genital, anal, or oral sex practices with an infected partner. The condition leads to the formation of genital warts
• Condyloma Acuminatum of Vagina is caused by the human papilloma virus (HPV) type 6 or less commonly by HPV type 11. The infection typically manifests as a benign skin and mucous membrane growth on the genitalia. The warts appear as multiple, soft, skin-colored growths. They may not remain confined to the vagina
• Informing and educating the infected individuals on the importance of safe sex is essential to prevent the spread of HPV infection, and thus of Vaginal Condyloma Acuminatum
• Many treatment options are available for women with the condition. However, there is a possibility for the infection to return, even on competition of successful treatment of Condyloma Acuminatum of Vagina

Who gets Condyloma Acuminatum of Vagina? (Age and Sex Distribution)

• It is estimated by the US Centers for Disease Control and Prevention (CDC) that around 50% of all sexually-active individuals may become infected with the genital human papilloma virus
• Condyloma Acuminata of Vagina most commonly occurs in sexually-active individuals that include teenage girls and young adult women; but, it can also occur in older women
• The infection occurs worldwide; there is no ethnic or racial preference observed

What are the Risk Factors for Condyloma Acuminatum of Vagina? (Predisposing Factors)

The risk factors for Condyloma Acuminata of Vagina include:

• Unprotected sex or sexual contact with an infected individual
• Multiple sexual partners
• Early age of sexual contact
• Having sexual contact with an individual whose sexual history is not known
• Smoking: Smokers have a 3.7 times higher risk for Vaginal Condyloma Acuminata than non-smokers
• Alcohol consumption
• A weak immune system particularly increases one’s risk for infections, such as for Vaginal Condyloma Acuminatum
• The use of birth-control pills: The use of oral contraceptives carries a risk that is 10 times higher than those who do not use such pills

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Condyloma Acuminatum of Vagina? (Etiology)

Condyloma Acuminata of Vagina is caused by the human papilloma virus (types 6 and 11) and is a sexually-transmitted disease (STD). The HPV is a very small microorganism that is transmitted through sex.

• The subtypes of the virus commonly associated with condyloma acuminata are type 6 and 11, and less commonly types 16,18,31,33, and 35
• It is transmitted from one individual to another through direct sexual contact with an infected partner; the infection can occur through genital, anal, or oral sex practices 
• Direct skin to skin contact of genital areas is sufficient for infection and to get the genital warts. This implies that a penetrative intercourse is not really necessary for the spread of infection
• The use of erotic devices can spread the infection
• Immunosuppression can also cause other HPV types (apart from HPV-6 and HPV-11) to infect the individual

What are the Signs and Symptoms of Condyloma Acuminatum of Vagina?

There can be various presentations with Condyloma Acuminata of Vagina. It may take anywhere from 1-8 months following exposure to present any signs and symptoms. The signs and symptoms of Condyloma Acuminata of Vagina may include:

• Frequently, the lesions or warts are present in multiple numbers; less commonly they may occur as only a single lesion/wart
• In most individuals, the condition may not cause any discomfort such as pain or itching
• The warts are generally present as small to large growths. These may occur in clusters. Some of these clusters give the appearance of a cauliflower. Sometimes, the warts are small enough that they are not visible to the naked eye
• The lesions are usually soft to touch in regions where it is moist
• Apart from the vagina, the warts may be present on the opening of the cervix or urethra
• There may also be skin-colored genital warts on the vulva
• Some individuals may have itching or burning sensation
• Some women may complain of bleeding or pain during intercourse

In some cases, individuals may have the infection, but may not have visible warts. This is called subclinical infection, or the individuals are called carriers (not having signs or symptoms). A subclinical infection is common. These individuals also have the potential to unknowingly infect other sexual partners.

How is Condyloma Acuminatum of Vagina Diagnosed?

The following procedures may be used to diagnose Condyloma Acuminata of Vagina:

• Thorough evaluation of the individual’s medical history and a complete physical examination, which includes examination of the vagina, vulva, thigh, anus, perineum, and adjacent skin
• Information about one’s personal history of sexual practices, barrier methods used, and a history of other sexually transmitted diseases
• Condyloma Acuminatum of Vagina is usually diagnosed by their characteristic appearance during the physical (pelvic) examination. The physician may also look for signs and/or tests to confirm the presence of other STDs, precancerous or cancerous lesions, etc.
• Colposcopy, a device to look closely into the vulva, vagina, and cervix for the presence of abnormal or infected areas. A biopsy can be taken during a colposcopy and HPV testing performed
• Vaginal Pap smear: Cells are collected from the region and examined under the microscope for associated precancerous or cancerous lesions
• Human papilloma virus tests: These tests are performed on the cells taken during a Pap smear examination, to check for the presence of HPV DNA
• Tissue biopsy and histopathology: In this procedure, the physician removes a sample of the wart tissue and sends it to the laboratory for a histopathological examination. The pathologist examines the biopsy under a microscope and arrives at a definitive diagnosis after a complete evaluation of the clinical and microscopic findings, as well as by correlating the results of special studies, such as HPV DNA testing, ISH, or PCR on tissues (if required)

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Condyloma Acuminatum of Vagina?

The complications of Condyloma Acuminata of Vagina include:

• Recurrence of the infection after treatment
• Scarring of the genitalia
• During pregnancy, these genital lesions can become active (may become big), may cause bleeding, or interfere with childbirth
• A vertical transmission of HPV infection during childbirth has not been conclusively proven; however, Condyloma Acuminata of Vagina can place vaginally-delivered babies at high risk for (future) ‘juvenile recurrent respiratory papillomatosis’
• The presence of lesions on the genitalia can cause severe stress in some individuals
• The genital warts usually do not become cancerous. Nevertheless, certain less-common viral types can cause cervical cancer

How can Condyloma Acuminatum of Vagina be Treated?

In some individuals, if the lesions are asymptomatic, then having no treatment is an option. The treatment options for Condyloma Acuminata of Vagina in case of signs and symptoms include:

• Medications: Topical medications that can be applied directly over the warts and in the region of infection may be prescribed. It may take several months before the warts completely disappear. The topical medications include:
  • Imiquimod: It acts by increasing the body’s immunity to fight the warts. It is advised to avoid sexual contact while using this medication, as it can weaken latex condoms causing breakage, and it may irritate the partner’s skin
  • Podophyllin: It acts by destroying the wart tissue. This application ointment is not to be applied internally and is not to be used during pregnancy. Podophyllotoxin is a purified form derived from podophyllin
  • Trichloroacetic acid: It acts by destroying the wart tissue and is applied by the physician
• Surgical treatment: Surgery may be warranted if the wart is big, not responding to medication, or if the individual is pregnant. The surgery may cause a swelling, pain, redness, or even a scar. The options available include:
  • Cryotherapy: Liquid nitrogen is used to freeze the wart tissue and form a blister on the skin. The wart sloughs off as the blister heals
  • Surgical excision: The wart can be removed using simple surgical tools as an outpatient procedure
  • Electrocautery involves burning-off the wart tissue using an electrical current
  • CO2 laser treatment for destroying the wart
• Counselling and treatment of one’s partner is important to prevent spread of the disease
• Follow-up is necessary to see if treatment options are working favorably and for follow-up, in case of other associated conditions

Despite the variety of treatment options available to remove warts, there is a possibility for them to recur. Successful visible wart treatment nevertheless leaves residual viral DNA in the local epidermal cells.

How can Condyloma Acuminatum of Vagina be Prevented?

The preventative measures for Condyloma Acuminatum of Vagina include:

• Use of condoms (practicing safe sex)
  • It is important to note that your partner may not have visible warts, but he/she may have the infection
  • Warts (visible and not visible, subclinical) on skin and mucosal surfaces not covered by a condom can be transmitted via skin-to-skin contact during sexual activity
• Avoiding multiple partners; try to maintain monogamous relationships
• If possible, avoid sexual contact with individuals having genital warts
• Vaccines are available against HPV (for both males and females between the ages 9 and 45 years) to help prevent cervical cancer, and genital warts caused by the less-common carcinogenic HPV seroptypes, 16 and 18

Inform your partners if you are being treated for the condition so they can be tested and treated if necessary for HPV.

What is the Prognosis of Condyloma Acuminatum of Vagina? (Outcomes/Resolutions)

• Condyloma Acuminata of Vagina has a variable prognosis; it varies from one individual to another
• The infection may subside on its own, with or without treatment
• It may recur (come back) after a successful treatment; sometimes, even many years after a successful treatment

Additional and Relevant Useful Information for Condyloma Acuminatum of Vagina:

It is important to note that other HPV types especially 16 and 18 cause cervical cancer. And other types, apart from 6, 11, 16, and 18 cause warts in other parts of the body.