Condylomata Program
Condylomata, or condyloma, are warts caused by the human papilloma virus (HPV) and are most frequently transmitted by sexual contact. They are the the most common sexually transmitted disease in the United States, and the incidence seems to be increasing. For all practical purposes, they occur only on the anal area and penis in men and the anal area and vagina/cervix in women (the latter in women are treated by gynecologists).
The Anal Condylomata Program at Cedars-Sinai Medical Group is a confidential program providing complete diagnostic and treatment services for adults and teenagers with anal condylomata. As a trusted name in healthcare and rated #1 in the Greater Los Angeles area for overall quality of care*, Cedars-Sinai Medical Group ensures that patients receive comprehensive, personalized care from a highly experienced staff and board-certified physicians.
Signs And Symptoms
Anal warts usually appear as white raised irregular lesions at the anal area, often with a "cauliflower-like" appearance (although there is a wide variation, sometimes appearing pigmented or flat). They are visible to the patient on the outside of the anus but are frequently present inside the anus as well, making treatment of the internal warts mandatory if treatment is to be effective.
Transmission
The warts are transmitted by direct contact of the virus, from an infected to uninfected individual. The incubation period for warts to become visible is about three months but can range from three weeks to eight months. Condoms may decrease the transmissibility but are not entirely effective because the condom does not cover the entire shaft of the penis or the scrotal area, both of which can serve a source for transmission.
Risks
HPV disease carries the risk of developing a dysplasia (pre-malignancy) and squamous cell carcinoma (cancer of the anal canal). The greatest risk factor for HPV disease is immunosuppression (diseases, such as HIV infection, that suppress the immune system).
Treatment
Although HPV cannot be "cured," the visible warts can be eradicated. This is done to rid the patient of physical symptoms, social problems and the malignant potential of visible warts. Presumably eradication of the warts reduces the likelihood of transmission to others--although neither this nor the infectiousness of the virus (when warts are not visible) is known.
There are several methods with varying effectiveness to treat anal warts. These include electrodessication (use of an instrument designed to destroy warts), surgical excision, laser, cryotherapy (freezing of warts), Interferon injections (an antiviral drug), topical immune modulator creams, cytotoxic chemical preparations applied by the surgeon and cytotoxic chemical preparations applied by the patient. The most appropriate treatment(s) will be determined by the surgeon, who is a specialist in this area, based on the extent of the disease and the patient's response to treatment.
Most treatments are brief and are performed in the physician's office, allowing the patient to immediately return to work with little interruption to the day. If, however, the patient has extensive disease outside the anus, the first treatment may be done in an operating room under sedation so the patient experiences no pain. This is a brief outpatient procedure.
The physician checks the patient for recurrences until they are confirmed free of external warts.
Expert Surgeon
Gregory Tsushima, MD, is a board-eligible general surgeon with Cedars-Sinai Medical Group. He is a member of the American College of Surgeons and the Society of American Gastrointestinal Endoscopic Surgeons. Dr. Tsushima earned his bachelor's degree from the University of Hawaii and his medical degree from the University's John A. Burns School of Medicine. He also completed an internship and residency at Cedars-Sinai Medical Center, where he served as chief resident
Payment
Cedars-Sinai Medical Group accepts self-pay, most forms of insurance and Medicare. Patients should contact their health plans directly to inquire about coverage.
For More Information
For more information about the Condylomata Program at Cedars-Sinai Medical Group, please contact:
| Cedars-Sinai Medical Group |
| 8635 W. Third St., Suite 870W |
| Los Angeles, CA 90048 |
| Phone: (310) 423-0289 |
| Alt Phone: (800) 700-6424 Member Services |
| Fax: (310) 423-0134 |
*Los Angeles Times, 9/25/00
