Further Outpatient Care
Patients typically are monitored on a periodic basis to assess for efficacy of treatment, unwanted side effects, and the development of complications. Outpatient follow-up care also provides an opportunity to evaluate for other sexually transmitted diseases (STDs) and provides patient education on an ongoing basis.
Deterrence/Prevention
Vaccines for human papillomavirus (HPV) infection (ie, Gardasil Cervarix) have been approved by the US Food and Drug Administration.
Complications
Disease complications can include progression to malignancy and transmission to other sexual contacts. In the setting of genital warts active during a pregnancy delivery, there is a small risk of laryngeal papillomatosis.
Each therapeutic modality carries its own unique set of risks. Risks of individual medical options are discussed in Treatment. Expected effects of cryosurgery include pain, edema, vesicles, bullae, weeping, and some necrosis. There is a small risk of infection, bleeding, abnormal scarring, pigment alteration, paresthesias, and alopecia with cryosurgery. Similarly, laser surgery of genital warts may result in pigment alteration, abnormal scarring, and infection. Special care must be taken to prevent respiratory infection from the laser plume generated by vaporization of virally infected tissue.
Prognosis
Prognosis is good, and most cases of genital warts are amenable to treatment. Patients who are immunosuppressed with genital warts may represent a special challenge.
Patient Education
Patients with genital warts deserve a focused history and physical examination, with appropriate testing to assess for other STDs. In a population study, 7% of men and 31% of women who had genital warts had concurrent STDs. In fact, 28% of these men and 71% of women had other STDs before or after their genital warts. Additionally, several consort studies documented that 30% of female consorts and 80% of male consorts had HPV infection. Usually, the same type of HPV involved both parties, and often they were HPV 6, 11, 16, and 18.
The benefit of evaluating sex partners of patients with genital warts has been apparent.
For patient education resources, see the Sexually Transmitted Diseases Center, as well as Genital Warts.
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