Остроконечные кондиломы

15.04.2012 , Dmitry Kiyachenkov

condyloma-acuminatum.jpg - kopie
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Остроконечные кондиломы - это вирусное инфекционное заболевание поражающее область гениталий, также известное как половые бородавки. Кондилома имеет вид выростов, сужающихся к вершине. Лечение кондиломы включает в себя как хирургическое удаление, так и применение цитотоксических веществ и использование нового противовирусного крема имиквимод.

Остроконечные кондиломы

Остроконечные кондиломы (половые бородавки) - это вирусное инфекционное заболевание, поражающее область гениталий. Первые упоминания о нем появляются уже в древнегреческой литературе. Возбудитель кондилом - вирус папилломы человека, обычно для него используется сокращение ВПЧ. Кондилома относится к заболеваниям, передающимся половым путем. Наиболее подверженные группы - женщины в возрасте около 20 лет и гомосексуалисты.

Вирус папилломы человека

ВПЧ или вирус папилломы человека довольно широко распространен среди нашей популяции. Вирус передается половым путем и, согласно исследованиям, его носителями являются 80-90% сексуально активных взрослых людей. Благодаря иммунной системе организм с ним хорошо справляется. Проблема заключается в том, что существует около 100 типов ВПЧ и некоторые из них могут вызывать у женщин рак шейки матки, реже - вульвы и влагалища. У мужчин ВПЧ может вызывать рак полового члена. У обоих полов ВПЧ может стать причиной остроконечных кондилом.

Симптомы кондилом

В течение своей жизни вирусом папилломы заразится до 80% людей, однако лишь у малой части он проявится в виде кондилом. ВПЧ размножается в месте проникновения инфекции - обычно это слизистая или микроскопические трещины на коже гениталий. Кондиломы имеют вид небольших белесых или красноватых выростов, сужающихся к основанию. При ранении сильно кровоточат. Кондиломы могут появляться одиночно, но чаще всего они растут в скоплениях, иногда сливаясь друг с другом. В запущенном случае, при недостаточном осмотре и у людей со сниженным иммунитетом могут напоминать по форме цветную капусту.

У мужчин появляются на внутренней стороне крайней плоти, на уздечке, головке и устье уретры. В исключительных случаях кондиломы прорастают по всей поверхности пениса и формируют так называемую гигантскую кондилому. У женщин появляется на больших и малых половых губах, клиторе и шейке матки. Кроме гениталий они могут прорасти в области анального отверстия и промежности. Нередко кондиломы возникают в области уголков губ, между пальцами или в других местах, связанных с сексуальной активностью. Первые симптомы появляются достаточно поздно, в среднем от 1 до 6 месяцев.

Диагностирование остроконечных кондилом

Кондиломы диагностируются прежде всего на основании клинической картины, однако, кроме этого можно провести взятие образцов для биопсии, мазок или серологическое исследование на предмет наличия антител против ВПЧ.

Лечение кондилом

Благодаря своему характерному виду распознать кондиломы несложно. Тем не менее, у мужчин их можно спутать с безвредными папулами вокруг головки полового члена, которые называются перламутровые папулы и совершенно точно не могут быть поводом для беспокойства.

Лечение остроконечных кондилом довольно сложное и во всех случаях требует врачебной помощи. Наросты можно устранить хирургическим путем с помощью скальпеля, лазера или заморозки. Для заморозки (криализации) используется жидкий азот, который врач наносит ватным тампоном на наросты. Благодаря физическому воздействию низкой температуры, клетки кондилом отмирают.

Остроконечные кондиломы также можно лечить поверхностным нанесением цитотоксических препаратов. Эти препараты представляют собой клеточные яды, которые предотвращают деление клеток. В некоторых местах, где находятся небольшие остроконечные кондиломы, можно произвести быстрый соскоб хирургической ложкой.

Имиквимод - новейший препарат в лечении кондилом. Он представляет из себя крем, который необходимо наносить на поврежденные места. Такая форма лечения приносит хорошие результаты и снижает риск возврата кондилом.

В том случае, если кондиломами заражена беременная женщина, при родах может произойти перенос инфекции на ребенка. Впоследствие у него может появиться заболевание дыхательных путей под названием папиламатоз гортани. Эта болезнь характеризуется появлением небольших доброкачественных опухолей в гортани ребенка. Такие опухоли могут вести к затруднению дыхания и обычно требуют повторного хирургического лечения, потому что после удаления опухоли на ее месте часто вырастает новая. Хотя это заболевание появляется крайне редко, наличие остроконечных кондилом у беременной женщины должно рассматриваться в качестве причины для проведения кесарева сечения.

Профилактика кондилом

Сексуальное воздержание - единственная надежная меры защиты от кондилом. Презервативы дают высокую степень охраны, однако ВПЧ может присутствовать на коже незащищенных при сексе областей, через которые может произойти заражение. Даже половой контакт с партнером без кондилом не гарантирует, что он не является носителем скрытой ВПЧ инфекции и не может ее распространять. В последние годы стала доступна профилактика в виде вакцинации. Вакцина содержит антитела не только против штамма ВПЧ, который вызывает кондиломы, но и против родственных типов, ответственных за такие тяжелые женские заболевания, как рак шейки матки.

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