The signs and symptoms of condyloma acuminata include the following features:

• The warts are flesh colored and round in shape. They can take the shape of cauliflower or can appear flat.
• The warts usually do not cause any pain or discomfort; however they can bleed and even cause pain during sexual intercourse if they are located in the vaginal region.

• Swelling

  Risks Laser surgery may cause any of the following: Pain, swelling, or itching Discharge from the vagina or penis Sores in the area treated Tissue that sticks together Shedding of dead tissue Scarring Urination that occurs in a wide, spraying stream, [northshore.org]

  In appearance, genital warts are often flesh-colored or gray swellings. If several cluster together, they may resemble a cauliflower. Some may be too small to be seen by the naked eye. [medicalnewstoday.com]

  In men, 5- fluorouracil applied bid to tid is highly effective for urethral lesions, but rarely, it causes swelling, leading to urethral obstruction. [merckmanuals.com]

  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. [dovemed.com]

• Weakness

  Only 35% and 30% of foreskins demonstrated weak staining in the basal layer cells. [ncbi.nlm.nih.gov]

  I've read that the blood and urine test often come back negative because they are "weak" tests and the only way to confirm is by taking a sample from the sore it's self. [patient.info]

• Localized Pain

  pain and ulceration Can neutralize with sodium bicarbonate solution Yes Yes Excision 14 (grade B, level I) † 35–72 19–79 Local anesthesia then excision of lesions Pain, bleeding, infection Yes Yes Electrocautery 14 (grade B, level II) † 61–94 22 Local [ncbi.nlm.nih.gov]

  80 20 to 65 Surgical excision Simple warts: $210 Extensive warts: $318 Pain (100), bleeding (40), scarring (10); risk for burning and allergic reaction from local anesthetic 35 to 70 20 Trichloroacetic acid Simple warts: $513 Extensive warts: $966 Local [aafp.org]

• Skin Disease

  Other names: Condyloma; Genital Warts; Venereal Warts Health Guide Disease Reference Care Notes Medication List About Condylomata Acuminata: A viral skin disease characterized by a soft wart-like growth on the genitals. [drugs.com]

  5-aminolevulinic acid-photodynamic therapy (ALA-PDT) is a treatment approach for proliferative and neoplastic skin diseases. It includes topical application of ALA and subsequent irradiation with visible light. [dermquest.com]

  A small number of case reports demonstrate an association between treatment with imiquimod cream and worsened inflammatory or autoimmune skin diseases (e.g., psoriasis, vitiligo, and lichenoid dermatoses) ( 771-773 ). [cdc.gov]

  Anogential warts in Treatment of Skin Disease ed Lebwohl M, Heymann WR, Berth-Jones J, Coulson I. Mosby London 2002. 28. Stone KM, Becker TM, Hadgu A, Kraus SJ. [dermatology.cdlib.org]

• Burning Sensation

  sensation in the genital and anal region especially if the case is already severe. [ehealthwall.com]

  You may have a mild to moderate burning sensation during the treatment. Genital warts in the urethra or anus usually require the most treatments because the warts may be inside the opening. [northshore.org]

  Patients should be advised that they may experience pain, burning sensation, inflammation and itching on the area where the cream is applied to. These creams are contraindicated in pregnant women for they can cause birth defects [1, 2]. [medicalfoxx.com]

  sensation surgery: a doctor or nurse can cut, burn or laser the warts off – this can cause irritation or scarring freezing: a doctor or nurse freezes the warts, usually every week for 4 weeks – this can cause soreness It may take weeks or months for [nhs.uk]

• Vaginal Discharge

  A discharge with a large number of white blood cells in a patient who does not have cervicitis suggests trichomonas. Candida Candida vaginitis may elicit no vaginal discharge, merely causing vulvar and/or vaginal erythema. [ncbi.nlm.nih.gov]

  discharge There will be also a sign of vaginal itching Sometimes bleeding can occur during or after sexual intercourse Pain especially if the wart is located at cervix and vagina There will be a visible tiny papules in the males penis There is a possible [ehealthwall.com]

  Women Be aware of the following after treatment for vaginal or cervical warts : A watery vaginal discharge may occur for about 1 to 3 weeks. Sanitary napkins should be used instead of tampons for 2 to 3 weeks. [northshore.org]

  discharge Genital itching Vaginal bleeding during or after sex The health care provider will perform a physical exam. [nlm.nih.gov]

• Genital Lesions

  Danya Reich, Corinna Eleni Psomadakis and Bobby Buka, Genital Lesions: Molluscum Contagiosum and Warts, Top 50 Dermatology Case Studies for Primary Care, 10.1007/978-3-319-18627-6_32, (199-209), (2016). [doi.org]

  Gissman L, Schneider A: Human papillomavirus DNA in preneoplastic and neoplastic genital lesions. In R Peto, H zur Hansen (Eds): Banbury Report 21. New York: Cold Spring Harbor, 1986, pp. 217–224. Google Scholar 4. [link.springer.com]

  The presence of lesions on the genitalia can cause severe stress in some individuals The genital warts usually do not become cancerous. [dovemed.com]

• Cesarean Section

  As this is a rare, non-malignant condition, and it is unclear whether the newborn becomes infected during birth or post partum, cesarean section is not recommended for prevention (grade C, level II). 4 There is a consensus of expert opinion that attempts [cfp.ca]

  Whether cesarean section prevents respiratory papillomatosis in infants and children also is unclear ( 781 ) ; therefore, cesarean delivery should not be performed solely to prevent transmission of HPV infection to the newborn. [cdc.gov]

  Cesarean section is not absolutely indicated. Few documented cases of HPV transmission to infant at time of delivery have resulted in laryngeal papillomas, a rare and life-threatening condition. HPV vaccination is contraindicated in pregnancy. [tipsdiscover.com]

  Additionally, no controlled studies have suggested that cesarean section prevents this condition. The one clinical indication for c-section that involves HPV is the presence of extensive vaginal and/or introital warts blocking the birth canal. [web.archive.org]

• Vaginal Bleeding

  […] discharge Genital itching Vaginal bleeding during or after sex The health care provider will perform a physical exam. [nlm.nih.gov]

  Vaginal bleeding during pregnancy may be due to condyloma eruptions. Latent illness may become active, particularly with pregnancy and immunosuppression. Lesions may regress spontaneously, remain the same, or progress. Pruritus may be present. [emedicine.medscape.com]

Diagnosis of condyloma acuminata begins with a past medical history of the disease and sexual life of the affected individuals. Following this, the following diagnostic procedures are carried out:

• Tests for sexually transmitted diseases.
• Pap smear test to detect acanthosis, nuclear abnormality, koilocytic abnormality and papillomatosis. 
• Filter hybridization is also required for analyzing the genotype of HPV involved.
• Biopsy of the warts is required to confirm the diagnosis if the warts harden and appear to be darker than the skin color.

• Human Papillomavirus

  In situ hybridization of the paraffin-embedded material revealed infection with human papillomavirus types 6/11. [ncbi.nlm.nih.gov]

  papillomavirus infection ( A63.0 ) viral warts due to human papillomavirus infection ( B07 ) ICD-10-CM Diagnosis Code B34 Viral infection of unspecified site 2016 2017 2018 2019 Non-Billable/Non-Specific Code Type 1 Excludes anogenital human papillomavirus [icd10data.com]

It is difficult to cure condyloma acuminatum. The treatment regimes are geared towards effective resolution of the warts and prevent the spread of the viral infection to rest of the body. The following are the various methods employed for treating condyloma acuminatum:

• Application of imiquimod cream [4] and podofilox gel to the affected area daily for a period of 8 weeks. These work by boosting the immune system to ward off the virus from the body. The medicated creams should be avoided by pregnant women and couples should not wear the cream during sexual activity [4].
• Cyrotherapy is often the treatment of choice when the warts have enlarged and do not respond to medications. It is the method of freezing warts by use of liquid nitrogen [5].
• Surgery is required when there are multiple warts causing great discomfort to the patient [6].
• Laser treatment is employed when there are several warts in the urethra or vaginal region. This carbon dioxide photodynamic option reserves the least recurrence rate for condyloma acuminatum [7].
• Ultrasound guided harmonic scalpel may be used to remove anorectal lesions [8].

Several treatment cycles would be required for resolving the warts. However, if the warts do not respond to 6 consecutive treatment cycles then the patients are usually given other treatment regime.

Condyloma acuminatum cannot be cured. However, with appropriate treatment the conditions can be managed in about 60 to 90% of cases. Warts may reappear after specific periods, but cannot turn cancerous in nature if managed well with treatment. Failure to initiate appropriate treatment regime can pave way for secondary complications.

Complications

Individuals suffering from condyloma acuminate when fail to receive medical attention are at risk of developing anogenital cancer [2]. Patients pose a potential risk of suffering from esophageal, lung and bladder cancer. Also, there are high chances of developing cancer of the vagina, vulva, anus and penis [3].

Infections by HPV are the major causative factor. Two genotypes 6 and 11 are known to trigger majority of the cases of condyloma acuminatum. In addition, genotypes 16 and 18 are also considered to be high risk because these are known to cause cervical and anal cancer. These genotypes however have minimal association with genital warts. The factors that increase the risk of contracting HPV include:

• Being sexually active with multiple partners
• Practicing sex without any protection
• Smoking
• Delivery through an infected vaginal canal [1]

In the United States, the prevalence of condyloma acuminatum has been reported to be more than 50%. Teenagers and young adults are more susceptible to develop genital warts; with the rate of incidence been highest for individuals aged 20 to 24 years. It has also been estimated that women are more prone to contract genital warts than males.

The human papillomavirus causes condyloma acuminatum. The virus enters the human system by invading the basal cells of the epidermis. After gaining entry the virus causes development of mucosal microabrasions. Individuals can live with no signs and symptoms for several weeks to months. After the latent phase, the formation of warts takes place. The most commonly affected regions include the vagina, cervix, penis, perianal area, vulva and perineum.

Condyloma acuminatum can be prevented by practicing safe sex or abstaining from sexual activity. It is also advised that men or women have only one sexual partner and that they refrain from having sex with multiple partners. HPV cannot be prevented by using condoms during sexual intercourse.

Vaccine known as Gardasil has been introduced that protects against 4 strains of HPV infections [9]. Therefore, about 90% cases of condyloma acuminatum can be prevented with this vaccination.

Condyloma acuminatum, commonly referred to as genital warts is one of the most common forms of sexually transmitted diseases. It is caused by human papillomavirus (HPV) affecting millions of individuals across the globe. There are over 100 strains of HPV and subtypes 6 and 11 are known to trigger majority of the cases of condyloma acuminatum. Individuals who are sexually active with multiple partners fall easy prey to HPV infections.

Definition

Condyloma acuminatum is a disease characterized by development of warts in the genital region. It is one of the most common types of sexually transmitted diseases and should receive prompt diagnosis and treatment to avoid onset of cancer. It is caused due to human papillomavirus (HPV) that has more than 100 strains. Of these, 2 genotypes 6 and 11 are known to cause the majority of genital warts. It has been estimated that about 75 – 80% of sexually active men and women can fall prey to condyloma acuminatum.

Cause

Infection by HPV is the major cause of condyloma acuminatum. The infections spread by skin to skin contact with an infected person. Factors such as having multiple partners and smoking also increase the risk of contracting genital warts.

Symptoms

Usually genital warts are present with no symptoms. These are round shaped and flesh colored. However, they can sometimes cause discomfort, pain and bleed during intercourse.

Diagnosis

Visual examination of the warts followed by biopsy would help in achieving an appropriate diagnosis. In addition, laboratory tests to identify the strain of HPV involved and Pap smear test would also be carried out.

Treatment

Condyloma acuminatum cannot be cured. The warts can be resolved and the spread of infection avoided with proper and rigorous treatment regime. Application of topical agents on the warts along with various therapies forms the basis of treatment regime. In addition, in case of multiple warts surgical procedures may be required. Also, cryotherapy can be conducted for freezing the warts.

1. Sinal SH, Woods CR. Human papillomavirus infections of the genital and respiratory tracts in young children. Semin Pediatr Infect Dis. Oct 2005; 16(4):306-16.
2. Nordenvall C, Chang ET, Adami HO, Ye W. Cancer risk among patients with condylomata acuminata. Int J Cancer. 2006; 119(4):888-93 (ISSN: 0020-7136)
3. Kishimoto T, Mabuchi S, Kato H, Kimura T. Condyloma acuminata induces focal intense FDG uptake mimicking vaginal stump recurrence from uterine cervical cancer: a case report. Eur J Gynaecol Oncol. 2013; 34(1):99-100 (ISSN: 0392-2936)
4. Haidopoulos D, Diakomanolis E, Rodolakis A, Vlachos G, Elsheikh A, Michalas S. Safety and efficacy of locally applied imiquimod cream 5% for the treatment of condylomata acuminata of the vulva. Arch Gynecol Obstet. 2004; 270(4):240-3 (ISSN: 0932-0067)
5. Tzathas C, Stavrianeas NG, Triantafyllou K, Triantafyllou G, Ladas SD. Long-term follow-up of endoscopic therapy of anal canal condylomata acuminata with podophyllotoxin. J Eur Acad Dermatol Venereol. 2007; 21(3):364-7 (ISSN: 0926-9959)
6. Zimmerman EE, Crawford P. Cutaneous cryosurgery. Am Fam Physician. Dec 15 2012; 86(12):1118-24.
7. Safi F, Bekdache O, Al-Salam S, Alashari M, Mazen T, El-Salhat H. Management of peri-anal giant condyloma acuminatum--a case report and literature review. Asian J Surg. Jan 2013; 36(1):43-52.
8. Zhu X, Chen H, Cai L, Yu Z, Cai L. Decrease recurrence rate of condylomata acuminata by photodynamic therapy combined with CO2 laser in mainland China: a meta-analysis. Dermatology. 2012; 225(4):364-70.
9. Colombo-Benkmann M, Tübergen D, Buchweitz O, Senninger N. Ultrasonic technology: a new treatment option for anal condylomata acuminata.Dis Colon Rectum. 2008; 51(11):1681-5 (ISSN: 1530-0358)
10. FDA News Release - Oct 16, 2009. FDA Approves New Indication for Gardasil to Prevent Genital Warts in Men and Boys. Accessed November 30, 2009.