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What are the symptoms of genital warts?

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Genital warts appear as painless, flesh-coloured or greyish-white growths on the vulva (along the greater and lesser labia and at the entrance to the vagina), anus or penis. They can be so small that they are only visible under a microscope, or they may gain a cauliflower-like appearance, which can be unsightly, itchy or mildly painful. When very large or extensive, they can even prevent intercourse or childbirth. When they infect the vagina, a discharge can develop and there may be painful intercourse. In men the warts may appear as tiny growths around the tip or shaft of the penis.

Diagnosis

Your doctor will gather important clues by asking you about the history of your complaint. He or she will examine the lesions and will often be able to make a diagnosis on the basis of their characteristic appearance.

Other diseases can be present simultaneously and therefore blood tests are often performed to exclude syphilis, gonorrhoea and other sexually transmitted diseases. Swabs may be collected for culture.

When to see your doctor

Whenever genital lesions develop, a doctor should be seen to establish an accurate diagnosis. Often genital warts cause a great deal of anxiety; this can be helped by obtaining realistic information about the disease, along with supportive counselling.

Vaginal discharge and painful intercourse should also arouse suspicion of a genital infection, and require a visit to a doctor.

Regular Pap smears of the cervix are generally advised in women over 35 years in order to detect abnormalities that may indicate premalignant or suspicious cell growth. These suspicious cells in the cervix may indicate early changes in cell growth, known as cervical intraepithelial neoplasia or CIN that may have occurred due to infection with particular "high-risk" types of HPV, like types 16 and 18. CIN lesions are early warning signs of cervical cancer. It is important to note however, that the types of HPV that cause genital warts, types 6 and 11, do NOT cause cancer of the cervix.

(Reviewed by Professor Lynette Denny, Gynaecology Oncology Unit, Department Obstetrics & Gynaecology, University of Cape Town/Groote Schuur Hospital, August 2008)

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