Warts on the glans penis

Condyloma acuminatum is a viral infection of the skin. Condyloma acuminatum can grow not only on female genitals, but also on the glans of some men. Condyloma acuminatum is like small fleshy granules, which may cause local itching. People always want to scratch it. Condyloma acuminatum is very easy to get infected if it is broken. Let's see what to do if you have condyloma acuminatum on the glans?

Clinical manifestations of male condyloma acuminatum

This disease often has no conscious symptoms, and some patients may experience local pain or itching. The basic damage is initially small light red bumps of varying sizes, distributed singly or in clusters, moist and soft, with nipple-like, cockscomb-shaped or cauliflower-like protrusions, red or dirty gray, often with pedicles at the roots, and prone to erosive exudates, and easy to bleed when touched. Purulent secretions often accumulate in the cracks of skin damage, causing a foul odor, and secondary infections are often caused by scratching. Due to continuous local moisture and chronic stimulation, it often grows rapidly. This disease often has no conscious symptoms, and some patients may experience local pain or itching. Occasionally, it can transform into squamous cell carcinoma.

The most common sites of this disease are the coronal sulcus, glans penis, foreskin, frenulum of the foreskin, urethral opening, urethra, penis body and root, perineum, around and inside the anus (rectum), and groin.

The incubation period of male condyloma acuminatum is 3 weeks to 8 months, with an average of 3 months. It is more common in sexually active young and middle-aged men, with the peak age of onset being 20 to 25 years old. Male patients with a course of 3 to 5 months will develop the disease soon after sexual contact; while male patients with an average course of 12 months may not develop the disease in sexual contact. Subclinical infection refers to lesions that cannot be identified by the naked eye clinically, but 3% to 5% acetic acid solution can be applied topically or wet-applied for 5 to 10 minutes to show that the HPV-infected area turns white, which is the so-called "acetic acid white phenomenon."

treatment

The treatment of male condyloma acuminatum must adopt comprehensive treatment: treating the cause (phimosis, gonorrhea), improving the body's immunity, and applying antiviral drugs. Generally, as long as you adhere to the standard comprehensive treatment, it can be cured. Physical treatment can also be used, such as laser, electrocautery, freezing, etc. First of all, you need to enhance the body's immunity.

1.Surgery

Treatment causes: prepuce is too long, gonorrhea. For single, small warts, surgical removal is possible; for giant condyloma acuminatum, Mohs surgery can be used for removal. During surgery, frozen sections are used to check whether the damage has been removed cleanly.

2. Cryotherapy

Using liquid nitrogen at -196℃, cryotherapy is used to treat condyloma acuminatum, which promotes the necrosis and shedding of wart tissue. This method is suitable for warts with a small number and small area. One to two treatments are feasible, with an interval of one week.

3. Laser therapy

Condyloma acuminatum is usually treated with CO2 laser and ablation. This treatment is most suitable for penile or perianal warts. Single or a small number of multiple warts can be treated once, while multiple or large warts can be treated 2 to 3 times, usually with an interval of one week.

4. Electrocautery

Use high-frequency electroacupuncture or electrosurgery to remove the warts. This treatment is suitable for warts that are small in number and area.

5. Microwave therapy

Microwave surgery is used for treatment. Under lidocaine local anesthesia, the tip of the rod-shaped radiation probe is inserted into the condylar wart directly to the base of the wart. When the wart is seen to become smaller, darker in color, and change from soft to hard, the thermal radiation coagulation is complete and the probe can be withdrawn. The coagulated lesion can be removed with tweezers. To prevent recurrence, the remaining base can be coagulated again.

6. Beta-ray therapy

This method has good efficacy, is painless, harmless, has few side effects, and has a low recurrence rate, and has clinical promotion value.

7. Drug therapy

(1) Podophyllum resin This treatment is suitable for wet warts in moist areas, such as wet warts on the glans penis that occur in patients with excessive foreskin and who have not undergone circumcision. Apply 20% podophyllum resin tincture to the skin lesions, or use an oily antibacterial ointment to protect the normal skin or mucous membranes around the skin lesions before applying the medicine. Wash with 30% boric acid water or soapy water 4 to 6 hours after application. Repeat the application after 3 days if necessary. This drug is the first choice for the treatment of this disease abroad, and it can usually be cured after one use.

(2) Currently, antiviral drugs are mainly macrocyclic triterpenes. The main treatment principle is that macrocyclic triterpenes can kill HPV viruses hidden in the skin and mucous membranes. The treatment course of this type of drug is long, and the warts fall off slowly, but the recurrence rate is very low.

(3) Corrosive agents or disinfectants commonly used are 30% to 50% trichloroacetic acid, saturated dichloroacetic acid, or 18% peracetic acid. Use 10% salicylic acid, glacial acetic acid, or a 100ml mixed solution of 40% formaldehyde, 2% liquefied phenol, and 75% ethanol distilled water, apply it topically, and apply it to the glans penis and perianal wet warts once a day or every other day. The effect is very good. Disinfectants can be applied externally with 20% iodine tincture, or 2.5% to 5% iodine tincture can be injected into the base of the wart or applied externally with Sanger-Mer, or applied externally with 0.1% to 0.2%. The latter needs to be combined with systemic treatment.

(4) Anticancer drugs ①5-fluorouracil (5-Fu) 2.5% to 5% fluorouracil wet compresses are used to treat penile and perianal condylar warts. Polyethylene glycol can also be used as a base, and 5% of 5-Fu powder can be added to make suppositories to treat male urethral condylar warts. 5-Fu base injection can also be used, and more can be injected in batches. ②Thiotepa is mainly used for urethral condylar warts that have failed to be treated with 5-Fu, and the side effect is urethritis. 10mg of this product can also be added to 10ml of saline to soak the affected area to treat male penile and glans glans coronal sulcus warts. It is mainly used for those who still have residual warts or relapses after treatment with other methods. This solution can also be diluted twice and soaked locally to prevent recurrence. ③ Colchicine can be applied externally in a 2% to 8% physiological saline solution to treat penile warts. Superficial erosion may occur after application.