What are the other Names for this Condition? (Also known as/Synonyms)
- Condyloma Acuminata of Vulva
- Condylomata Acuminata of Vulva
- Vulvar Condyloma Acuminatum
What is Condyloma Acuminatum of Vulva? (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 Vulva 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 lumps. They generally may not remain confined to the vulva
- Most individuals need no treatment, but informing and educating the infected individuals on the importance of safe sex is essential to prevent the spread of HPV infection, and thus of Vulvar Condyloma Acuminatum
- Many treatment options are available, however there is a possibility for the infection to return, even after competition of a successful treatment
Who gets Condyloma Acuminatum of Vulva? (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 Vulva 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 Vulva? (Predisposing Factors)
The risk factors for Condyloma Acuminata of Vulva 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 Vulvar 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 Vulva? (Etiology)
Condyloma Acuminata of Vulva 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 sex play-toys can help spread the infection
What are the Signs and Symptoms of Condyloma Acuminatum of Vulva?
There can be various presentations with Condyloma Acuminata of Vulva. It may take anywhere from 1-8 months following exposure to present any signs and symptoms. The signs and symptoms of Condyloma Acuminata of Vulva may include:
- Frequently, the lesions or warts are present in multiple numbers; less commonly they may occur as only a single lesion/wart. The genital warts are usually skin-colored (flesh-colored)
- 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. Some of these clusters give the appearance of a cauliflower. Sometimes, the warts are very small that they are not visible to the naked eye
- The lesions are usually soft to touch in regions where it is moist, such as on the vulva
- Apart from the vulva, the warts may be present on the opening of the cervix 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 or symptoms). A subclinical infection is common. These individuals also have the potential to infect other non-infected individuals.
How is Condyloma Acuminatum of Vulva Diagnosed?
The following procedures may be used to diagnose Condyloma Acuminata of Vulva:
- 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 Vulva is usually diagnosed by their characteristic appearance during the physical 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
- Pap smear: Cells are collected from the tip of the womb (cervix) 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
- 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 Vulva?
The complications of Condyloma Acuminata of Vulva 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
- The presence of lesions on the genitalia can cause severe stress in some individuals
- The genital warts usually do not become cancerous. Nevertheless, they may have associated cancer-causing HPV infection that may later cause cancer
How can Condyloma Acuminatum of Vulva be Treated?
In some individuals, if the lesions are asymptomatic, then having no treatment is an option. The treatment options for Condyloma Acuminata of Vulva in case of signs and symptoms include:
- Medications: Topical medications that can be applied directly over the warts 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 dampen the condoms’ effect, or 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
- 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 in the health center
- Electrocautery: It 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 a variety of treatment options available to remove the warts, there is a possibility for it to recur, because the treatments available are mostly aimed at removing the warts and not the underlying infection, which caused the warts.
How can Condyloma Acuminatum of Vulva be Prevented?
The preventative measures for Condyloma Acuminatum of Vulva 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 Vulva? (Outcomes/Resolutions)
- Condyloma Acuminata of Vulva has a variable prognosis; it varies from one individual to another
- The infection may subside on its own, with or with 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 Vulva:
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.