Genital Warts- Why you should not ignore those painless bumps
Jul 12, 2009
SHAMIM, 25, had small, fleshy growths in her private parts (vagina) but because they were painless, she ignored them. However, they grew into ugly large, pink, cauliflower-like lumps. They caused her a lot of discomfort which affected her normal gait.<br
By Irene Nabusoba
SHAMIM, 25, had small, fleshy growths in her private parts (vagina) but because they were painless, she ignored them. However, they grew into ugly large, pink, cauliflower-like lumps. They caused her a lot of discomfort which affected her normal gait.
“They would itch. When I visited a herbalist, she told me that I was suffering from ekinanansi. Another said it was kifene (jack fruit). Nonetheless, they gave me herbs but the growths did not clear.
“When I was pregnant, my husband insisted that we go to hospital for proper diagnosis for the sake of the baby. He had also developed tiny bumps on the tip of his penis,†Shamim discloses.
Her husband’s advice was very timely. Shamim, who was in her last trimester, was diagnosed with genital warts and booked for a Caesarean section.
“Doctors said if I was to try a natural delivery, I risked not only my health because the swellings would burst and bleed, but also infecting my baby,†she says.
What are genital warts?
Dr. Daniel Zaake, an obstetrician/ gynaecologist at Nsambya Hospital, says genital warts are a highly contagious sexually transmitted infection caused by sub-types of human papillomavirus (HPV).
He says there are over 100 types of HPVs, but only about 40 have the potential to infect the genital area.
“About 90% of genital warts are caused by two specific types of the virus; HPV-6 and -11,†Zaake says, adding that other HPV types have been strongly associated with premalignant changes and cervical cancers in women, particularly HPV-16, which is responsible for about 50% of cervical cancers, while types 18, 31 and 45 account for 80% of cancers.
However, the genital warts-causing HPV types are considered “low risk,†having a low cancer-causing potential just like the common warts, often seen on the feet and fingers, or on some other parts of the skin, which are apparently not the same as genital warts and are caused by different HPV types.
Signs and symptoms
According to wikipedia, genital warts often occur in clusters and can be very tiny or can spread into large masses.
“In women, they occur on the outside and inside the vagina, on the cervix or around the anus. They are approximately as prevalent in men, but the symptoms may be less obvious.
They are usually seen on the tip of the penis, shaft, scrotum or around the anus,†it says.
Rarely, the site notes, genital warts can also develop in the mouth or throat of a person who has had oral sex with an infected person.
Dr. Milton Awudo of MarieStopes Uganda, an international reproductive health organisation, says although genital warts are painless, they may be bothersome because of their location, size, or due to itching.
Awudo says their size may range from less than one millimetre across to several square centimetres when many warts join together.
“Men and women with genital warts will often complain of painless bumps, itching and discharge. Rarely, bleeding or urinary obstruction may be the initial problem when the wart involves the urethral opening,†he says.
The warts, he says, can appear as soft, raised masses with a surface that can be smooth or rough with many finger-like projections.
Others may appear pearly, cauliflower-like or rough with a slightly dark surface.
Understandably, most lesions are raised, but some may be flat with only slight elevation above the skin surface. Infection with HPV may be dormant or undetectable, with some lesions hidden by hair or in the inner aspect of the uncircumcised foreskin in males.
While in women, lesions visible on the outer genitals warrant a thorough examination of the vaginal canal, cervix and anorectal area. Most vaginal warts occur without symptoms.
“Rarely, women may experience bleeding after sexual intercourse, itching or vaginal discharge,†Awudo says.
Doctors warn that warts that obstruct the urethral opening are an emergency and should be treated as soon as possible.
Impact on pregnancy
A BBC health report says genital warts often appear or increase in number during pregnancy, which may also activate dormant infections.
The report says the presence of genital warts may make vaginal delivery difficult if they are in the cervix or vagina. Warts in these locations tend to bleed easily.
“The warts often disappear on their own after pregnancy.
The real danger, however, is that newborns may become infected during passage through an infected birth canal,†it says.
The site warns that infection with genital warts can cause a serious condition in children called recurrent respiratory papillomatosis (RRP).
“This is a life-threatening disease of the respiratory tract. The papillomas or warts appear and spread quickly, blocking the child’s airway,†it says.
Dr. Samuel Kalisoke, the head of the obstetric department at Mulago Hospital, echoes the concerns: “During pregnancy, warts can grow in size and obstruct the birth canal, making delivery difficult. They may also bleed as the baby passes through the birth canal.
“If an expectant mother has genital warts, we normally advise that we deliver her by Caesarean section because if they try the natural way, they can bleed excessively and also infect the baby because the infection is very contagious.â€
Causes of genital warts
Doctors say genital warts are the most common sexually transmitted infections although many people carrying the virus that causes them may have no physical symptoms.
Apparently, the virus can remain in the body and be passed on before the warts are noticeable, or after they have disappeared.
An online medical encyclopaedia, www.wikipedia.com says the infection is spread through direct skin-to-skin contact during oral, genital or anal sex with an infected partner, but can also be transmitted by skin-to-skin contact with someone who has it.
“The viral particles are able to penetrate the skin and mucosal surfaces through microscopic abrasions in the genital area, which occur during sexual activity,†it explains.
“Once cells are invaded by HPV, a latency (quiet) period of months to years may occur, but generally, two-thirds of people who have sexual contact with a partner who has genital warts develop them within three months,†it adds.
The site says less than 1% of those infected develop clinically obvious warts, but they can still transmit the virus. Over 70% of those who have sexual contact with an infected partner develop genital warts.
Zaake adds: “They are highly infectious. We often use gloves but should you accidentally touch the swellings, you can develop the warts on your fingers.â€
SHAMIM, 25, had small, fleshy growths in her private parts (vagina) but because they were painless, she ignored them. However, they grew into ugly large, pink, cauliflower-like lumps. They caused her a lot of discomfort which affected her normal gait.
“They would itch. When I visited a herbalist, she told me that I was suffering from ekinanansi. Another said it was kifene (jack fruit). Nonetheless, they gave me herbs but the growths did not clear.
“When I was pregnant, my husband insisted that we go to hospital for proper diagnosis for the sake of the baby. He had also developed tiny bumps on the tip of his penis,†Shamim discloses.
Her husband’s advice was very timely. Shamim, who was in her last trimester, was diagnosed with genital warts and booked for a Caesarean section.
“Doctors said if I was to try a natural delivery, I risked not only my health because the swellings would burst and bleed, but also infecting my baby,†she says.
What are genital warts?
Dr. Daniel Zaake, an obstetrician/ gynaecologist at Nsambya Hospital, says genital warts are a highly contagious sexually transmitted infection caused by sub-types of human papillomavirus (HPV).
He says there are over 100 types of HPVs, but only about 40 have the potential to infect the genital area.
“About 90% of genital warts are caused by two specific types of the virus; HPV-6 and -11,†Zaake says, adding that other HPV types have been strongly associated with premalignant changes and cervical cancers in women, particularly HPV-16, which is responsible for about 50% of cervical cancers, while types 18, 31 and 45 account for 80% of cancers.
However, the genital warts-causing HPV types are considered “low risk,†having a low cancer-causing potential just like the common warts, often seen on the feet and fingers, or on some other parts of the skin, which are apparently not the same as genital warts and are caused by different HPV types.
Signs and symptoms
According to wikipedia, genital warts often occur in clusters and can be very tiny or can spread into large masses.
“In women, they occur on the outside and inside the vagina, on the cervix or around the anus. They are approximately as prevalent in men, but the symptoms may be less obvious.
They are usually seen on the tip of the penis, shaft, scrotum or around the anus,†it says.
Rarely, the site notes, genital warts can also develop in the mouth or throat of a person who has had oral sex with an infected person.
Dr. Milton Awudo of MarieStopes Uganda, an international reproductive health organisation, says although genital warts are painless, they may be bothersome because of their location, size, or due to itching.
Awudo says their size may range from less than one millimetre across to several square centimetres when many warts join together.
“Men and women with genital warts will often complain of painless bumps, itching and discharge. Rarely, bleeding or urinary obstruction may be the initial problem when the wart involves the urethral opening,†he says.
The warts, he says, can appear as soft, raised masses with a surface that can be smooth or rough with many finger-like projections.
Others may appear pearly, cauliflower-like or rough with a slightly dark surface.
Understandably, most lesions are raised, but some may be flat with only slight elevation above the skin surface. Infection with HPV may be dormant or undetectable, with some lesions hidden by hair or in the inner aspect of the uncircumcised foreskin in males.
While in women, lesions visible on the outer genitals warrant a thorough examination of the vaginal canal, cervix and anorectal area. Most vaginal warts occur without symptoms.
“Rarely, women may experience bleeding after sexual intercourse, itching or vaginal discharge,†Awudo says.
Doctors warn that warts that obstruct the urethral opening are an emergency and should be treated as soon as possible.
Impact on pregnancy
A BBC health report says genital warts often appear or increase in number during pregnancy, which may also activate dormant infections.
The report says the presence of genital warts may make vaginal delivery difficult if they are in the cervix or vagina. Warts in these locations tend to bleed easily.
“The warts often disappear on their own after pregnancy.
The real danger, however, is that newborns may become infected during passage through an infected birth canal,†it says.
The site warns that infection with genital warts can cause a serious condition in children called recurrent respiratory papillomatosis (RRP).
“This is a life-threatening disease of the respiratory tract. The papillomas or warts appear and spread quickly, blocking the child’s airway,†it says.
Dr. Samuel Kalisoke, the head of the obstetric department at Mulago Hospital, echoes the concerns: “During pregnancy, warts can grow in size and obstruct the birth canal, making delivery difficult. They may also bleed as the baby passes through the birth canal.
“If an expectant mother has genital warts, we normally advise that we deliver her by Caesarean section because if they try the natural way, they can bleed excessively and also infect the baby because the infection is very contagious.â€
Causes of genital warts
Doctors say genital warts are the most common sexually transmitted infections although many people carrying the virus that causes them may have no physical symptoms.
Apparently, the virus can remain in the body and be passed on before the warts are noticeable, or after they have disappeared.
An online medical encyclopaedia, www.wikipedia.com says the infection is spread through direct skin-to-skin contact during oral, genital or anal sex with an infected partner, but can also be transmitted by skin-to-skin contact with someone who has it.
“The viral particles are able to penetrate the skin and mucosal surfaces through microscopic abrasions in the genital area, which occur during sexual activity,†it explains.
“Once cells are invaded by HPV, a latency (quiet) period of months to years may occur, but generally, two-thirds of people who have sexual contact with a partner who has genital warts develop them within three months,†it adds.
The site says less than 1% of those infected develop clinically obvious warts, but they can still transmit the virus. Over 70% of those who have sexual contact with an infected partner develop genital warts.
Zaake adds: “They are highly infectious. We often use gloves but should you accidentally touch the swellings, you can develop the warts on your fingers.â€