Vaginal Warts Research Articles

Prevalence of high-risk human papillomavirus infection and cervical lesions among female migrant head porters (kayayei) in Accra, Ghana: a pilot cross-sectional study

BackgroundLittle attention has been given to the risk of high-risk human papillomavirus (hr-HPV) infection and cervical precancerous lesions among female migrant head porters (kayayei) in Ghana, as a vulnerable group, and to promote cervical screening in these women. This pilot study aimed to determine the prevalence of hr-HPV infection and cervical lesions among kayayei in Accra, the capital of the Greater Accra Region of Ghana and to describe our approach to triaging and treating these women.MethodsThis descriptive cross-sectional cohort study involved the screening of 63 kayayei aged ≥ 18 years at the Tema Station and Agbogbloshie markets in March 2022 and May 2022. Concurrent hr-HPV DNA testing (with the MA-6000 platform) and visual inspection with acetic acid (VIA) was performed. We present prevalence estimates for hr-HPV DNA positivity and VIA ‘positivity’ as rates, together with their 95% confidence intervals (CIs). We performed univariate and multivariable nominal logistic regression to explore factors associated with hr-HPV infection.ResultsGross vulvovaginal inspection revealed vulval warts in 3 (5.0%) and vaginal warts in 2 (3.3%) women. Overall, the rate of hr-HPV positivity was 33.3% (95% CI, 21.7–46.7), whereas the VIA ‘positivity’ rate was 8.3% (95% CI, 2.8–18.4). In the univariate logistic regression analysis, none of the sociodemographic and clinical variables assessed, including age, number of prior pregnancies, parity, past contraceptive use, or the presence of abnormal vaginal discharge showed statistically significant association with hr-HPV positivity. After controlling for age and past contraceptive use, only having fewer than two prior pregnancies (compared to having ≥ 2) was independently associated with reduced odds of hr-HPV infection (adjusted odds ratio, 0.11; 95% CI, 0.02–0.69).ConclusionIn this relatively young cohort with a high hr-HPV positivity rate of 33.3% and 8.3% of women showing cervical lesions on visual inspection, we posit that kayayei may have an increased risk of developing cervical cancer if their accessibility to cervical precancer screening services is not increased.

Clinical signs of genital papillomavirus infection

702 women were observed: the basic group consisted оf 450patients with sexual-transmitted infections (STI); control group included 252 women without STI. 19 women with oncological diseases of reproductive system were specially examined.The women with genital papillomavirus infection complained of itch, burning, and warts of anogenital area. The most widespread diseases in STI patients were cervical pseudoerosion and endocervicitis. In presence of HPV of high oncogenic risk in these women endocervicitis, vaginal warts and vulvovaginitis were diagnosed.High oncogenic risk of HPV was noticed in all women with the established diagnosis of cervical cancer.

Genital warts. Official statistics, clinical manifestations and effectiveness of therapy

Human papillomavirus infection (HPV) is one of the most common infections today. Young women have a high risk of infection with HPV. The contagiosity of the virus reaches 80%. HPV is a cause of cervical cancer. Genital warts is one of the most common clinical manifestations of HPV, the incidence is 120–150 per 100,000 population. The aim of the study was to assess the degree of incidence of vulvar and vaginal warts, according to the official statistical forms and clinical practice. The statistical forms do not give an accurate account of the incidence of HPV due to the characteristics of reporting. According to clinical observation, signs of HPV were detected in 23,3% of female students, who underwent periodic medical examinations, and in 10,1% of patients, who addressed complaints to the gynecologist. Inosine pranobex is the most studied systemic immunomodulator used to eliminate HPV. The non-intervention open-site single-center study showed that the effectiveness of monotherapy acounted for 66,9%, which categorized inosine pranobex as a first-line drug.

Indications for Caesarean Sections in Rundu State Hospital in Kavango East Region, Namibia

BACKGROUND: A caesarean section is a life saving procedure for both the mother and the baby. However, the fact that caesarean section rates are increasing worldwide, in both the developed and developing countries is becoming an issue of increasing concern, which raised a concern. The purpose of this study was to evaluate the indications for a caesarean section in the Rundu State Hospital. 
 
 METHODS: A cross sectional retrospective study was conducted.The study population comprised the records of women who had undergone caesarean section between 1 January 2017 to 31 March 2017. After conducting a sample size calculation the delivery, records of 149 women who had undergone a caesarean section during the study period were reviewed. The required data was collected using individual data collection sheets and then analysed using SPSS version 24.
 
 RESULTS: The age of participants ranged between 20 and 50 years. The mean age for the study group was 25.1 years. The overall leading indications for a caesarean section included foetal distress (25.6%), previous uterine scar (18.1%) and Cephalopelvic disproportion (16.1%) while other major contributing indications were eclampsia (16.1%), mal-presentation (8.1%), prolonged labour (6.7%, ante partum haemorrhage (3.4%), failed vaginal birth after caesarean section (2.0%), cord prolapse (1.3%) and severe vaginal warts (0.6%). In addition, the study found that a primary caesarean section was more common at 81.9% as compared to previous uterine scar at 18.1 % while maternal indications contributed to 61% of caesarean sections while foetal indications constituted 39%.
 
 CONCLUSION: Overall, the study found that the leading indications for caesarean section were foetal distress and previous uterine scar. It was recommended that foetal distress, as the main indicator for a primary caesarean section, should be further confirmed with a printed cardiotocograph. Training health workers on the interpretation of cardiotocograph and the importance of the use of other methods, such as the fetoscope and doptone, may help to reduce the incidence of unnecessary primary caesarean section due to foetal distress. In addition, previous uterine scar cases should be embark on labour before a decision is made.

Anogenital warts and other HPV-associated anogenital lesions in the HIV-positive patient: a systematic review and meta-analysis of the efficacy and safety of interventions assessed in controlled clinical trials

ObjectivesAnogenital warts (AGW, condylomata acuminata) and intraepithelial neoplasia (IEN) do not only impact health and social well-being, they are also associated with considerable costs for the healthcare systems. Immunocompromised and...

Knowledge of cervical cancer, HPV infection and vaccine in nursing students, nursing staff and female hospital workers in a tertiary care centre of North India.

Human Papilloma virus is one of the most common and dangerous sexually transmitted disease which affects around 50-80 % of women of reproductive age group. HPV is associated with a number of diseases like vaginal warts, anal warts, premalignant and malignant lesions of cervix. Present study is undertaken to assess the knowledge of cervical cancer screening, HPV infections, and HPV vaccination in nursing students, nursing staff and female hospital workers. A total of 110 nursing students, 80 nurses and 70 group D female workers were interviewed. Most of the nursing students had adequate knowledge about cervical cancer and screening followed by Staff nurses. Knowledge of HPV infection and vaccine is adequate in3/4 th of the nursing students and nursing staff. Female workers had inadequate knowledge of cervical cancer and screening and negligible knowledge of HPV infection and vaccine. We concluded that Healthcare employees should be involved in all the cervical cancer awareness programs initiated by hospital. If properly informed Hospital staff could be a useful link for spreading information from heath care systems to general public.

PM.93 A Complicated Case of Giant Vulval Condylomata in Pregnancy

Anogenital warts are one of the most common sexually transmitted diseases in the UK caused by HPV infection.1 2 The condition is not purely benign with significant symptoms present in...

Vulvo Vaginal Warts in Pregnancy and Spontaneous Regression after Delivery

Genital warts occur in sexually active women and therefore it is not uncommon to see its occurrence during pregnancy. However giant sized vulval condyloma occurring in pregnancy is rare. We present a series of three cases of extensive condyloma accuminata in pregnancy which posed difficulty in diagnosis and management. Patients were treated conservatively and delivered by caesarean section in view of soft tissue dystocia and laryngeal papillomatosis. The postnatal review was a total surprise and there was complete regression of all the three cases by the end of third month.

Diagnosis and treatment of vaginal intraepithelial neoplasia

ObjectiveTo audit our experience of the diagnosis and treatment of vaginal intraepithelial neoplasia (VAIN) in Kandang Kerbau Women's Hospital, Singapore. MethodsThe clinical records of the patients diagnosed as having VAIN at our institution in the calendar year 2009 were periodically reviewed until March 2011. ResultsThere were 21 cases of VAIN. The mean follow-up duration was 18.2months. The lesion grades were VAIN 1 in 9 patients (42.9%), VAIN 2 in 9 patients (42.9%), and VAIN 3 in 3 patients (14.3%). The mean patient age was 39.1years. Sixteen patients (76.2%) were referred to our institution because of abnormal results to cytology tests and 4 patients (21.9%) were referred because of vaginal warts. The remaining patient was diagnosed from a surgical specimen. The diagnosis involved a cytology test, a colposcopic examination, an acetowhite test, a Schiller test, and a colposcopy-directed biopsy. The treatments varied and included watchful waiting but carbon dioxide laser vaporization was used the most frequently. ConclusionAfter 6months of follow-up 18 patients were considered cured, for an overall cure rate of 85.7%. Two patients wanted no treatment and disease remained persistent in 1 patient despite laser vaporization and intravaginal applications of imiquimod cream.

Condyloma acuminatum: atypical presentation during pregnancy

Genital warts (condylomata acuminata) are caused by human papillomavirus (HPV) and are usually transmitted sexually. We present an atypical case of a vaginal wart presenting as a single pedunculated mass protruding outside the vagina in a pregnant woman in labour. On examination of the vulva, a soft, pink papilliferous growth of 6 × 4 cm size was seen hanging outside the vaginal introitus. Speculum examination revealed that the growth was attached to the posterior and lateral vaginal wall near the fornix. Genital warts can proliferate during pregnancy due to altered immunity and increased blood supply, as seen in this case. Vaginal warts can also cause problems during delivery, since they prevent the vagina from stretching appropriately.

VULVOVAGINAL WARTS AND NEOPLASIA IN HIV-POSITIVE WOMEN

BACKGROUND Several reports indicate higher rates of vulvar wats and vulvar intraepithelial neoplasia (IN) in HIV-seropositive women than in HIV-seronegative women. In this study, our goal was to determine the prevalence of vaginal and vulvar warts and neoplasia as defined by colposcopy and to evaluate the course of vaginal and vulvar warts and neoplasia on follow-up. METHODS: From 1991 to 1994, 285 HIV-seropositive women were enrolled in a study of the natural history of HIV disease and its gynecologic manifestations. At entry, the lower genital tract was evaluated by colposcopy and cytology. Vaginal and vulvar lesions were biopsied if suspicious for IN. Women were followed by pelvic exams and cytology every 6 months and by annual colposcopy. RESULTS: At study entry, 273 women had colposcopic evaluation of the lower genital tract. Four women (2%) had vaginal IN (VAIN) and 14 (5%) had vaginal warts. The prevalence of VAIN/warts in women with CD4 counts below 200 was 10% compared to 5% above 200 (p=0.15). One patient developed VAIN3 and two developed vaginal warts during follow-up. Mean CD4 count of VAIN patients was 200 and of patients with vaginal warts was 290. At baseline colposcopy, 2 women (1%) had vulvar IN (VIN) and 42 (15%) had vulvar warts. The prevalence of vulvar warts/VIN was 17% at CD4 counts < 200 compared to 15% > 200. Eight women developed vulvar warts on follow-up. Mean CD4 count of VIN patients was 289 and of patients with vulvar warts was 318. One patient with VAIN 3 treated by vaginectomy had no recurrence after 22 mos. Three of 4 patients with VAIN 1 treated by vaginal 5-fluorouracil cream, had persistent mild warts, but no evidence of VAIN (mean follow-up: 16 months). Three women had vaginal warts which persisted more than 12 months, while 9 had no further evidence of warts. One patient with untreated VIN 2 had persistent VIN2 more than 25 months after diagnosis. One patient with VIN 1 treated by LEEP had no recurrent VIN after 30 months. Of 9 patients with CD4 counts < 200, vulvar warts persisted in 33%, and in 30 patients with CD4 count > 200 vulvar warts persisted in 30%. CONCLUSION In HIV-seropositive women vulvovaginal IN and warts are more prevalent than reported in immunocompetent populations. However, with limited numbers, we observed no differences by severity of immunodeficiency. Meticulous surveillance of the entire lower genital tract including vagina, vulva and perineum should be a routine part of care for HIV-seropositive women.

An audit of treatment of genital warts: opening the feedback loop.

An audit of the treatment of patients (100 men and 90 women) presenting with a first episode of anogenital warts to the Genitourinary Medicine Department at Leeds General Infirmary was performed. Treatment of patients was monitored for a period of 6 months from the time of presentation. The management of patients with genital warts lacked a clearly defined strategy and treatment was unselective and poorly monitored. Excluding patients who defaulted, at follow-up 44 (44%) men and 36 (38%) women still had genital warts at 3 months. Of those patients clear of warts at 3 months, the mean time to remission for men and women was 7.1 and 8.3 weeks respectively. Podophyllin 25% in tincture of benzoin was by far the predominant therapeutic modality used. A total of 96 (96%) men and 76 (84%) women received treatment with podophyllin. Both male and female patients had a mean of 5 treatments with podophyllin 25% (range 1-19 and 1-12 respectively). Physical methods of treatment i.e. cryotherapy and electrocautery, were underutilized, both as primary therapies and when topical agents had failed. Patients saw an average of 3 (range 1-7) doctors over the course of their treatment. Patients with warts affecting 2 or more sites, male patients with anal/perianal warts, and female patients with cervical and vaginal warts had higher failure rates from treatment at 3 months. On the basis of these findings, specific treatment protocols for the management of anogenital warts have been devised.

Treatment of anogenital warts in genitourinary clinics in England and Wales.

A questionnaire on the treatment of anogenital warts was sent to 150 consultants in genitourinary medicine, 78 (52%) were returned completed. A wide range of treatments were used; podophyllin was the commonest first line treatment of multiple penile (60.3%), perianal (57.7%) and vulval (61.5%) warts. Cryotherapy was a popular choice for intrameatal warts (65.3%), small numbers of vulval warts (33.3%) and as second line therapy for penile (35.9%) and perianal (33.3%) warts. Vaginal warts were treated with podophyllin (39.7%) or cryotherapy (29.5%). Various combinations of podophyllin, trichloroacetic acid and cryotherapy were used (2.6%-24.3%) although there is no evidence this offers benefit over single therapy. Podophyllin is frequently used despite side effects, a poor clearance rate and in vaginal warts, difficult access. Initial therapy with more time-consuming procedures such as cryotherapy or electrocautery may be of benefit to selected patients.

Condyloma Acuminatum of the Oral Cavity

A 24-year-old man developed condyloma acuminatum on his penis and on the upper lip of his mouth approximately three months after his girl friend was diagnosed and treated for vaginal warts. Cunnilingus was the postulated method of spread to the lip. Condyloma acuminatum should be considered among the many sexually transmitted infections that affect both anogenital and oral areas.