What are the other Names for this Condition? (Also known as/Synonyms)
- Cervical Condyloma Acuminatum (CLA)
- Genital Wart of Cervix
- Low-Grade Squamous Intraepithelial Lesion (LSIL) - Condylomatous Variant
What is Condyloma Acuminatum of Uterine Cervix? (Definition/Background Information)
- Condyloma acuminatum is one of the most commonly transmitted sexual infections caused by the human papilloma virus (HPV). 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 Uterine Cervix is strongly associated with HPV type 6 and HPV type 11. The infection typically manifests as a benign wart on the mucous membrane of the cervix
- Treatment of the condition is necessary, since Condyloma Acuminatum of Uterine Cervix is termed as a variant of low-grade squamous intraepithelial lesion (SIL). Low-grade SIL is an early indicator for future ‘invasive carcinoma’ development
- The prognosis of Condyloma Acuminatum of Cervix depends upon 2 key factors, namely the type of HPV involved and the grade of the premalignant lesion present (whether low-grade or high-grade SIL)
- Informing and educating the infected individuals on the importance of safe sex is essential to prevent the spread of HPV infection, and thus of Cervical Condyloma Acuminatum
Who gets Condyloma Acuminatum of Uterine Cervix? (Age and Sex Distribution)
- Condyloma Acuminata of Uterine Cervix is uncommon, since the infection more commonly affects the exposed genital areas
- 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 most commonly occurs in sexually-active individuals that include teenage girls and young adult women; but, the infection 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 Uterine Cervix? (Predisposing Factors)
The risk factors for Condyloma Acuminata of Uterine Cervix 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 and alcohol
- A weak immune system increases one’s risk for infections, such as for Cervical Condyloma Acuminatum
- The use of birth-control 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 Uterine Cervix? (Etiology)
Condyloma Acuminata of Uterine Cervix is caused by the human papilloma virus (HPV 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; less commonly, types 16,18,31,33, and 35, may be involved
- HPV-6 and HPV-11 are categorized as low-risk HPVs, meaning that the risk for cervical cancer from these viruses is lower compared to other high-risk HPVs (such as HPV-16 or 18)
- 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 sex play-toys can also help spread the infection
What are the Signs and Symptoms of Condyloma Acuminatum of Uterine Cervix?
There can be various presentations with Condyloma Acuminata of Uterine Cervix. It may take anywhere from 1-8 months following exposure to present any signs and symptoms. The signs and symptoms of Cervical Condyloma Acuminata may include:
- The presence of a wart or an abnormal growth on the mucosal surface of the cervix
- 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 lumps. These may occur in clusters
- Apart from the cervix, the warts may be present on the opening of the vulva or urethra
- 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 and symptoms). A subclinical infection is a common occurrence. Such individuals have the potential to infect other non-infected individuals too.
How is Condyloma Acuminatum of Uterine Cervix Diagnosed?
The following procedures may be used to diagnose Condyloma Acuminata of Uterine Cervix:
- Thorough evaluation of the individual’s medical history and a complete physical examination, which includes examination of the cervix, 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
- The physician may also look for signs and/or tests to confirm the presence of other STDs, precancerous or cancerous lesions, etc.
- Pap smear: Cells are collected from the tip of the cervix and examined under the microscope for any associated precancerous or cancerous lesions. Pap smear results may indicate abnormalities such as low-grade squamous intraepithelial lesion
- Human papilloma virus tests: These tests are performed on the cells taken during a Pap smear examination, to check for the presence of HPV
- 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
- 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 Uterine Cervix?
The complications of Condyloma Acuminata of Uterine Cervix include:
- Recurrence of the infection after treatment
- During pregnancy, these lesions can become active (may become big), may cause bleeding, or interfere with childbirth
- Cervical Condyloma Acuminata is a variant of low-grade squamous intraepithelial lesion (SIL), which are asymptomatic lesions, but present a low risk for future cancer
How can Condyloma Acuminatum of Uterine Cervix be Treated?
In some individuals, if the lesions are asymptomatic, then having no treatment is an option. The treatment options for Condyloma Acuminata of Uterine Cervix in case of signs and symptoms include:
- Surgical treatment: Surgery may be warranted if the wart is big, not responding to medication, or if the individual is pregnant. 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 in the health center
- Electrocautery: It involves burning-off the wart tissue using an electrical current
- CO2 laser treatment for destroying the wart
- Topical medications, in case of any visible external genital warts, can be applied directly over the warts
- Counseling 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 to monitor for recurrences
How can Condyloma Acuminatum of Uterine Cervix be Prevented?
The preventative measures for Condyloma Acuminatum of Uterine Cervix include:
- Use of condoms (practicing safe sex)
- It is important note that your partner may not have visible warts, but he/she may have the infection
- Even non-condom areas can have subclinical infection and infection can occur on contact with these areas
- Avoid 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 26 years) to help prevent cervical cancer and genital warts
- Do inform your partners if you are being treated for the condition; besides, they too might have the same infection and require treatment
What is the Prognosis of Condyloma Acuminatum of Uterine Cervix? (Outcomes/Resolutions)
- The prognosis of Condyloma Acuminata of Uterine Cervix is dependent upon the type of HPV involved in the infection and the grade of the squamous intraepithelial lesion (SIL)
- With adequate treatment, the condition can resolve within 12 months. However, it is known to recur (genital warts may form at other sites); sometimes, even many years after a successful treatment
Additional and Relevant Useful Information for Condyloma Acuminatum of Uterine Cervix:
- Low-grade squamous intraepithelial lesion (LSIL) may upgrade to high-grade squamous intraepithelial lesion (HSIL), which portrays a much higher risk for invasive carcinoma in the future. Also, the presence of LSIL may be an indicator for HSIL at other adjacent sites
- When the specimen sample is examined under a microscope by the pathologist, the diagnosis may reveal that Condyloma Acuminata of Cervix exhibits the characteristics of acanthosis, papillomatosis, and koilocytosis