Chronic ulcerations following topical therapy with 5-fluorouracil for vaginal human papillomavirus-associated lesions

Article Abstract:

The drug, 5-fluorouracil (5-FU), can be applied directly to the surface of the vagina to treat lesions caused by human papillomavirus (HPV), such as genital warts or tumors in the outer tissues of the vagina. The long-term effects of 5-FU on the mucosal layer of the vagina were assessed in 220 patients treated with 5-FU for HPV-induced lesions. Epithelial ulcers developed in 18 women within six months after discontinuing 5-FU treatment. The incidence of ulcer formation was 9.6 percent after treatment with 5-FU for more than 10 weeks, and 5.7 percent after treatment with 5-FU for 10 weeks or less. The ulcers developed most often in the recesses of vagina and the ectocervix, a portion of the opening to the uterus. Patients mainly developed single ulcers measuring 0.5 to 7 centimeters in diameter. Ulcer-related symptoms developed in 77.8 percent of patients and included bloody or watery discharge in 55.6 percent; spotting or bleeding after intercourse in 44.4 percent; irregular bleeding in 16.7 percent; and pain in 5.6 percent. The ulcers took a long time to heal without treatment, but the use of estrogen creams or agents that destroy tissue did not hasten the healing process. Surgical removal of the ulcer and closing off the wound was effective in the four patients who underwent this procedure. These findings show that 5-FU applied to the vaginal surface may cause mucosal ulcers that are difficult to treat. (Consumer Summary produced by Reliance Medical Information, Inc.)

Complications and side effects, Drug therapy, Ulcers, Vagina, Fluorouracil

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Does the treatment of genital condylomata in men decrease the treatment failure rate of cervical dysplasia in the female sexual partner?

Article Abstract:

The sexual partners of many women with genital condylomata (warts) or cervical dysplasia (abnormal growth of cervical tissues) have genital human papillomavirus (HPV) infections. The male infection is thought by some to contribute to the spread of HPV among women, with resulting genital warts, cervical dysplasia, and cancer. Reinfection of women who have been treated for HPV is also attributed to HPV-infected men. Thus, treating men with HPV infection may be a desirable public health goal for women, and should also decrease the development of penile cancer. The association between treatment of genital warts in male sex partners and the failure rate of treatment for cervical dysplasia in 390 women was evaluated. Male partners of 190 women were treated for condylomata. Analysis of the records from these cases revealed that there was no significant difference in the treatment failure rate between the women whose partners were and were not treated. One theory explains this outcome by suggesting that the virus remains entrenched throughout the female genital tissues following the treatment of localized tissue changes. Although men with HPV infections should continue to be treated for their own health, screening and treating male partners of women with cervical dysplasia for the purpose of improving the women's treatment outcome are unlikely to be helpful. (Consumer Summary produced by Reliance Medical Information, Inc.)

Physiological aspects, Prognosis, Demographic aspects, Papillomaviruses, Papillomavirus

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Treatment failure of genital condylomata acuminata in women: role of the male sexual partner

Article Abstract:

Genital condylomata acuminata are sexually-transmitted genital warts caused by infection with human papillomavirus. Genital warts usually develop within three months of viral infection. However, many men with human papillomavirus do not develop symptoms of infection and are unaware of the genital lesions. These warts on the penis are contagious and can cause recurrent infection or treatment failure in an infected female partner. The efficacy of treating infected male partners in preventing recurrence of condylomata acuminata in women was assessed. The study included 360 women with genital condylomata acuminata. The male sexual partners of 180 women were assessed for the presence of genital warts and treated if necessary, whereas the remaining 180 male sexual partners were neither examined nor treated. Lesions caused by human papillomavirus infection were detected in 122 male sexual partners. Treatment for genital warts was unsuccessful in 16.7 percent of women whose male sexual partners were also treated, and in 18.9 percent of women whose male sexual partners were neither examined or treated. Thus, the rate of treatment failure was not significantly different among women with condylomata acuminata. These findings show that treating infected male sexual partners does not prevent the recurrence of genital warts in women. (Consumer Summary produced by Reliance Medical Information, Inc.)

Sexually transmitted diseases, Disease transmission

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