What are anal warts?
Anal warts (also called "condyloma acuminata") are a condition that affects the area around and inside the anus. They may also affect the skin of the genital area. They first appear as tiny spots or growths, perhaps as small as the head of a pin, and may grow quite large and cover the entire anal area. Usually, they do not cause pain or discomfort to afflicted individuals and patients may be unaware that the warts are present. Some patients will experience symptoms, such as itching, bleeding, mucus discharge and/or a feeling of a lump or mass in the anal area.
What causes anal warts?
They are caused by the human papilloma virus (HPV), which is transmitted from person to person by direct contact. HPV is considered a sexually transmitted disease (STD). You do not have to have anal intercourse to develop anal warts.
Do anal warts always need to be removed?
Yes. If they are not removed, the warts usually grow larger and multiply. Left untreated, the warts may lead to an increased risk of cancer in the affected area.
What treatments are available?
If warts are very small and are located only on the skin around the anus, they may be treated with a topical medication. They may also be treated by freezing the warts with liquid nitrogen or removed surgically. Surgery typically involves cutting or burning the warts off. While this provides immediate results, it must be performed using either a local anesthetic - such as novocaine - or a general or spinal anesthetic, depending on the number and exact location of warts being treated. It is important that an internal anal examination with an instrument called an anoscope be done by your treating physician to ensure you do not have any inside the anal canal (internal anal warts). Internal anal warts may not be as suitable for treatment by topical medications, and may need to be treated surgically. Additionally, your physician may wish to examine the entire pelvic region to include the vaginal or penile area to look for other warts that may require treatment.
Must I be hospitalized for surgical treatment?
Surgical treatment of anal warts is usually performed as outpatient surgery.
How much time will I lose from work after surgical treatment?
Most people are moderately uncomfortable for a few days after treatment and pain medication may be prescribed. Depending on the extent of the disease, some people return to work the next day, while others may remain out of work for several days to weeks.
Will a single treatment cure the problem?
When warts are extensive, your surgeon may wish to perform the surgery in stages. Additionally, recurrent warts are common. The virus that causes the warts can live concealed in tissues that appear normal for several months before another wart develops. As new warts develop, they usually can be treated in the physician's office. Sometimes new warts develop so rapidly that office treatment would be quite uncomfortable. In these situations, a second and, occasionally, third outpatient surgical visit may be recommended.
How long is treatment usually continued?
Follow-up visits are necessary at frequent intervals for several months after all warts appear to be gone, to be certain that no new warts occur.
What can be done to avoid getting these warts again?
In some cases, warts may recur repeatedly after successful removal, since the virus that causes the warts often persists in a dormant state in body tissues. Discuss with your physician how often you should be evaluated for recurrent warts. Abstain from sexual contact with individuals who have anal (or genital) warts. Since many individuals may be unaware that they suffer from this condition, sexual abstinence, condom protection or limiting sexual contact to single partner will reduce your potential exposure to the contagious virus that causes these warts. As a precaution, sexual partners ought to be checked for warts and other sexual transmitted diseases, even if they have no symptoms.
What is a colon and rectal surgeon?
Colon and rectal surgeons are experts in the surgical and non-surgical treatment of diseases of the colon, rectum and anus. They have completed advanced surgical training in the treatment of these diseases as well as full general surgical training. Board-certified colon and rectal surgeons complete residencies in general surgery and colon and rectal surgery, and pass intensive examinations conducted by the American Board of Surgery and the American Board of Colon and Rectal Surgery. They are well-versed in the treatment of both benign and malignant diseases of the colon, rectum and anus and are able to perform routine screening examinations and surgically treat conditions if indicated to do so.
author: Jennifer Lowney, MD, FASCRS, on behalf of the ASCRS Public Relations Committee
© 2012 American Society of