What are anal condylomata acuminata?
Anal condylomata acuminata are the most common sexually transmitted disease. Nowadays it is accepted that due to the use of the anus for pleasure it has increased in heterosexuals since it was always thought to be a disease of homosexuals.
What causes it and are there risk factors?
Condyloma acuminata is caused by the human papillomavirus, undoubtedly it has always been associated with homosexuality and, in fact, it is more frequent in homosexuals, but in heterosexuals due to the use of the anus for pleasure, it is quite common. And we have to take into account that it is even more frequent in patients who are carriers of the human immunodeficiency virus, AIDS.
Is it possible to prevent them?
Nowadays, the prevention of this very frequent disease of condylomata acuminata is being carried out from the point of view of primary prevention. There is the vaccine against human papilloma, it is being given more and more frequently and logically secondary prevention is going to be if we take into account the early diagnosis of these condylomas and, on the other hand, the use of condoms. Condoms are very important. But condoms should not be used exclusively once the relationship has begun. No, from the beginning, because just rubbing the area is enough to transmit the virus and also one thing we must always bear in mind is that the incubation period of this virus is between one month and six months.
What are the symptoms?
It is generally asymptomatic. Many patients simply come for consultation because they notice some lumps in the perianal area. In some cases they are itchy, the anal area itches due to the secretion of these condylomas. On other occasions they produce bleeding due to rubbing during defecation, the feces collide with these condylomas that are like warts when rubbed, they erode them and produce bleeding. But I insist that it is essential to go to the doctor for an examination, but an examination not only of the perianal area but also of the anal canal because it is an area that is frequently infected.
What does the treatment consist of?
The treatment has three parts. A pharmacological treatment, generally with ointments, a surgical treatment and an immunotherapy treatment, to stimulate the body’s defenses. It is important that we bear in mind what Gregorio Marañón said, “there are patients, not diseases”, so what is important is that we provide individualized treatment, depending on each specific case. If the patient only requires surgical treatment, which is the removal of these condylomas, or if, apart from this treatment, he/she needs an adjuvant treatment with ointments or immunotherapy. Generally when they are incipient they can be eliminated simply with ointments, podophyllin and other derivatives, imiquimod, which is in fashion, can be eliminated perfectly well. But we advise the treatment of surgical removal and in the specific case of our clinic we do it with diode surgical laser because it is a vaporization, a cleaning and in many cases when patients have problems with deficient defenses we have to complement the treatment with interferon or other substances that can regulate these defenses for the patient.