How to treat urethral warts

  Condyloma acuminatum (CA) is a common and recurring disease caused by human papilloma virus (HPV) infection of the genitals, perineum or anus mainly transmitted through sexual contact, CA occurring in the male anterior urethra is less common. Because of the special site, poor exposure, difficult operation, high recurrence rate and easy to cause urethral stricture, it has been a difficult point in the treatment of acromegaly, which brings difficulties in the complete clinical cure of this disease. This article introduces a treatment method for urethral condyloma that is effective, has a low recurrence rate, has few side effects and is economical and easy to use.  Treatment: The patient lies flat, routinely disinfects the towel, 2% lidocaine 0.5-1ml plus alpha-2b interferon 3 million units are injected at the base of the lesion, microwave is used to initially carbonize the CA lesion, and then combined with multifunctional ion cautery treatment, the depth does not exceed the submucosa layer, and then microwave is used to carbonize the wound. The normal tissues should be damaged as little as possible during the operation to reduce the incidence of urethral stricture. Patients have varying degrees of postoperative painful urination, which is mostly tolerated, and they are advised to drink more water. The traumatic surface is mildly congested and edematous, without obvious exudation, and no treatment is needed. A small amount of urethral bleeding may occur during urination and erection, and the bleeding can be stopped by compressing the penis if it is greater than 10 ml. Most of the cases with large surgical trauma are prone to urethral strictures, which appear from 2 weeks to 3 months after surgery and are mostly mild. Urethral CA combined with genitourinary system infection is treated with systemic antibiotics.  Relapse prevention: local closure of the urethra before interferon is given according to the rash, which is gradually reduced to every 2 weeks 1-2 times a week for 2-3 months. Most patients showed influenza-like symptoms 2-3 hours after the first injection and relieved by themselves after 6-12 hours. Individuals with fever over 38.5℃ can be physically cooled down or take oral phenolamine curative tablets, and influenza-like symptoms reduced or disappeared after several injections (average 3 times).  Regular review: 1-2 times a week within 1 month after surgery, and every 2 weeks if there is no recurrence, and once a month if there is still no recurrence after 1 month. The end of the last surgical treatment was used as the starting time, and clinical cure was considered if no new CA lesion was found and the white acetate test was negative for more than 6 months of continuous observation. The trauma heals in an average of 2 weeks. If new foci of acromegaly or foci of subclinical infection with a positive white acetate test are found, the lesions are removed immediately by surgery again.  Role of interferon: It is now generally accepted that the cause of persistent HPV infection is the inability of the body to establish an effective immune response, especially local cellular immunity. The main mechanism of interferon therapy for CA is shown in three aspects: 1. antiviral effect: interferon can interfere with HPV-DNA replication and mRNA transcription, thus affecting HPV virus replication and proliferation; 2. antiproliferative effect: that is, anti-HPV-induced proliferation of skin mucosal target cells, and local injection can reduce the formation of urethral scar; 3. immunomodulatory effect: improve the body’s immune function and enhance host’s defense response to HPV infection and prevent HPV reinfection and recurrence. Most scholars now believe that IFN can be used in patients with recurrent CA after failure of conventional treatment and as an adjuvant immunotherapeutic measure after removal of warts by physical therapy or drug therapy to reduce the recurrence rate of CA. Most studies have shown that local injections of interferon lesions are more effective than systemic administration for common condyloma acuminata.  The most important thing is that the treatment is not only for the patient, but also for the patient. (2) human papilloma virus is a pro-epidermal lesion mainly located in the spiny cell layer, interferon should be administered in a localized way as far as possible; there is no standardized plan for interferon treatment, but it should be given in sufficient amount and in sufficient duration; (3) regular examination of patients and spouses or sexual partners to detect and remove suspected lesions; timely treatment of genitourinary system diseases; wet compresses or sitz baths with 3% boric acid solution or 1:5000 potassium permanganate solution when the perineum is moist or has more secretions; (4) patient education to patients to relieve the psychological pressure caused by bad publicity. Active treatment of hepatitis B, diabetes and other systemic diseases, drug and alcohol detoxification, moderate exercise and regular lifestyle habits are also important to the cure of the disease.  Finally, I hope that all patients can cooperate with doctors to cure this CA, so that tomorrow will be better!