genital warts
[Local anesthesia in CO2 laser treatment of disseminated therapy-resistant condylomata]

[Article in Danish]

Petersen CS.

Dermatologisk afdeling, Kobenhavns Amts Sygehus, Gentofte.

In an open prospective study 67 patients with refractory genital warts, irrespective of anatomic localization, received CO2-laser vaporization in local anaesthesia, using lidocaine 2% as the local anaesthetic. Sufficient anaesthesia was obtained in all treated patients, with minor pain as the only side effect observed. A single CO2-laser treatment resulted in disappearance of the lesions in 37 (55%) of the patients. Repeated CO2-laser vaporizations in patients with recurrent disease increased the cure rate to 85%. The response rate seemed unaffected by the localization of the warts. It is concluded, that local anaesthesia might replace general anaesthesia in the treatment of patients with multiple refractory genital warts.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8317044&dopt=Abstract genital wart


genital warts
Detection of human papillomavirus DNA in the urogenital tracts of men with anogenital warts.

Hillman RJ, Botcherby M, Ryait BK, Hanna N, Taylor-Robinson D.

Division of Sexually Transmitted Diseases, Clinical Research Centre, Harrow, Middlesex, United Kingdom.

Increasing evidence suggests that human papillomavirus (HPV) infection of the female anogenital tract is multifocal. Less is known of the distribution of HPVs in men. To investigate this, a prospective study was conducted of 116 men consecutively attending a clinic for ablative treatment of anogenital warts. Wart tissue, urethral swabs, and urine were obtained from each patient. HPV DNA was extracted from the specimens and amplified using the polymerase chain reaction (PCR). HPV types 6, 11, 16, 18, 31, and 33 were identified using Southern blotting of the PCR product, followed by hybridization. HPV DNA was detected in 112 (96.6%) of 116 wart specimens and there was urethral infection with HPV in 26 (22.4%) of the men. Eleven (61.1%) of 18 urethral specimens taken with a loop and 22 (20.0%) of 116 urethral specimens taken using a cotton-tipped swab contained HPV DNA. One (6.3%) of 16 urine samples tested contained HPV DNA. HPV types 6 and 11 were found in the urethra most commonly when warts were seen near the urinary meatus, although HPV occurred in the urethras of men without clinically apparent meatal warts. The proportion of urethral samples with HPV DNA, including HPV types 16, 18, 31, and 33, was independent of the location of visible warts at the time of sampling.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8381560&dopt=Abstract genital wart


genital warts
Genital HPV infection not a local but a regional infection: experience from a female teenage group.

Rymark P, Forslund O, Hansson BG, Lindholm K.

Department of Obstetrics and Gynaecology, University of Lund, Malmo General Hospital, Sweden.

OBJECTIVES--To investigate the prevalence of human papillomavirus (HPV) infections in a group of female teenagers, and to analyse to what extent HPV DNA was also detectable, in urethra and cervix samples among the patients with macroscopic genital warts compared with those without. DESIGN--The patients were interviewed about their sexual habits and history of venereal diseases. They underwent a gynaecological health control examination, including macroscopic inspection for genital warts and collection of a cytological vaginal smear (Pap smear). Cell samples were also taken from endocervix and urethra and from vulva lesions, when found. These samples were tested for HPV DNA of the types 6, 11, 16, 18 and 33 using the polymerase chain reaction (PCR) technique. SETTING--An adolescence out-patient clinic in Malmo, Sweden. SUBJECTS--Forty-nine female teenagers consulting for gynaecological complaints, some of them for genital warts. RESULTS--Twenty patients had present and four had a history of genital warts (group A). The other 25 patients had no visible lesions (group B). In the first group (A) 18 of the 24 patients were positive for HPV DNA in one or more of the three locations studied. More patients were positive in urethra (17) than in cervix (15). In group B four of the 25 patients were positive for HPV DNA in urethra, three of these also in cervix. In the two groups 11 and four patients, respectively, showed pathological Pap smears. CONCLUSIONS--The finding of HPV DNA in urethra, both from women with and without visible genital warts, indicates that there is a high probability that the infection is also present in cervix, suggesting that the genital HPV infections are multifocal. Thus, patients with genital warts are most likely to have cervical HPV infections and will more often have pathological Pap smears than patients without warts.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8383095&dopt=Abstract genital wart


genital warts
Use of complementary therapies in a sexual health clinic setting.

Trutnovsky G, Law C, Simpson JM, Mindel A.

Manly Sexual Health Service, Manly Hospital, Sydney, Australia.

This prospective cohort study examined the health-seeking behaviour of patients diagnosed with genital warts and vulvodynia who presented to Manly Sexual Health Service from March to June 2000. A self-administered questionnaire was used to assess patients' perceptions of their condition and their use of complementary therapies. Thirty-seven patients with genital warts and 26 patients with vulvodynia participated in the study. The use of at least one complementary health product or method was reported by 59% of patients with genital warts and 96% of vulvodynia patients (P < 0.001). Having received conflicting information and being worried about the condition was significantly associated with visits to complementary health providers. Acknowledgement of this search for complementary therapies and open discussion can help patients make informed decisions and to avoid drug interactions, and should ultimately lead to better patient care.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11368804&dopt=Abstract genital wart


genital warts
Dual genitotropic human papillomavirus infections in genital warts.

Aznar J, Ojeda A, Torres MJ, Palomares JC, Rodriguez-Pichardo A.

STD Clinic, School of Medicine, University of Seville, Spain.

BACKGROUND AND METHODS--We have carried out a prospective study of dual genitotropic human papillomavirus (HPV) infections by means of two different DNA detection methods in biopsy specimens obtained from patients who were examined for genital warts at the STD clinic of the School of Medicine in Seville, between January 1990 and December 1991. RESULTS--100 patients with a clinical diagnosis of condilomata acuminata were seen during the study period. DNA of the genitotropic HPV 6/11, 16/18 and 31/33/35 was detected by an in situ hybridisation method in 75 (77%) of the 98 evaluable samples; one of the genotypes tested in 59 (61%) samples, and two or more genotypes tested in the remaining 16 (15%) samples. In 21 (98%) of the 23 negative samples by in situ hybridisation, we were able to detect DNA of genital HPV using a polymerase chain reaction amplification method (PCR). Among the 34 samples where PCR was applied we confirmed the presence of two different HPV genotypes in eight samples. CONCLUSIONS--The frequency of dual infections with human genitotropic papillomavirus in genital warts was 8%, although we believe that this rate should be higher as we have not used the PCR method in all of the samples.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8383097&dopt=Abstract genital wart