What are anal warts?
Anal warts (also called condyloma acuminata) are a relatively common and bothersome condition which affects the area around the anus. They also may affect the skin of the genital area.
Where do these warts come from?
They are caused by a virus which usually is transmitted from person to person through sexual contact. They can, however, be acquired through other means.
Do these warts always need to be removed?
Yes. If this is not done, the anal warts generally grow larger and more numerous. There is evidence that these warts can become cancerous if left for a long time without treatment.
What treatments are available?
Caustic liquid medicines
If the warts are very small and are located only on the skin around the anus, they can be treated with certain caustic liquid medicines which must be applied directly to the surface of the warts. This method, while relatively simple in concept, must be carried out with great care and precision, lest injury occur to the normal skin around the warts. This method usually takes several applications, performed at various intervals over several weeks. When anal warts are larger, more numerous, or located inside the anus, chemical therapy generally is ineffective.
Rapid destruction of the warts
Another form of treatment involves more rapid destruction of the warts, using electric cautery, surgical removal or a combination of the two. This gives immediate results but must be done using either a local anesthetic, such as Novocain, or a general or spinal anesthetic, depending on the number and particular location of the anal warts being treated.
Will a single treatment cure the problem?
Even with the cautery and surgical treatment, almost all people develop more anal warts after treatment. The virus can live in normal-appearing tissues for up to six months before causing a wart to develop. If warts do re-occur, they are thought to be new warts developing from the virus which was already in the tissue. As new warts develop, they usually can be treated in the office using either acid or the electric cautery. These treatments initially are done about once a month. As the new warts become less numerous and smaller, treatment ultimately diminishes to every two months. Sometimes the new anal warts develop so rapidly that office treatment would be quite uncomfortable. In such situations, a second and, occasionally, even a third visit to Day Surgery is recommended. If this is necessary, the discomfort afterwards normally is much less than after the first treatment.
Must I be hospitalized for surgical treatment?
No. The cautery and excision technique can be done in Day Surgery, and the patient can go home an hour or two later.
How long is treatment usually continued?
Follow-up visits are necessary until six months after the last anal wart is seen, to be certain that no more warts occur from viruses living in the cells of the skin.
How much time will I lose from work after a cautery treatment?
This depends upon the individual. Most people are moderately uncomfortable for a few days after the treatment (pain pills are provided for those patients requiring treatment in the operating room). Some people return to work the next day, while some maybe out for up to several days.
What can be done to avoid getting these warts again?
It is important to avoid re-infection from other individuals who may have this condition. Sexual partners should be examined by their physician.