A. Ender YUMRU, Murat BOZKURT, Davas İnci ERŞEN, Çölgeçen A. Emel ÖNAL

Condyloma accuminata olgularının özellikleri, klinik belirtileri ve tedavisinin güncel bilgiler ışığında incelenmesi

Anamnez ve klinik muayene sonucu vulvo-vajinit ön tanısı almış 107 olgunun, condyloma accuminata özellikleri, klinik belirtileri ve tedavisi incelenmiştir. Ocak 2000- Aralık 2001 tarihleri arasında Taksim Eğitim ve Araştırma Hastanesi Kadın Hastalıkları ve Doğum Polikliniği ve Şişli Etfal Eğitim ve Araştırma Hastanesi 2. Kadın Hastalıkları ve Doğum polikliniğine başvuran bu olguların; yaş, sigara içip içmedikleri, gebe olup olmadıkları, sosyoekonomik durum, meslekleri, partner sayıları ve kullandıkları kontraseptif yöntemleri açısından değerlendirilmiştir. Condyloma accuminata olgularının sosyoekonomik düzeyleri ve sigara içme durumları ile ilgisi anlamlı bulunurken (p0.05). 107 olgunun 15'i (%14) condyloma accuminata tanısı almıştır. Bu 15 vakanın 2'si gebedir. Gebe olgulara eksizyonel biyopsi, diğer 13 olguya elektrokoterizasyon uygulanmıştır. Condyloma accuminatanın toplumdaki sıklığının araştırılması gerekliliği vurgulanmıştır.

Anahtar Kelimeler:

Kondilomata akuminata, Gebelik, Sigara içme, Vulvovajinit, Siğiller, Cinsel yoldan bulaşan hastalıklar, viral, Papillomavirus enfeksiyonları

Condyloma accuminata cases characteristics - The evaluation of the clinical symptoms and treatment with current information

Clinical symptoms and the result of the treatment of condyloma accuminata in 107 case, which had diagnosis of vulvovaginitis after the clinical examinations and the patient history. These cases appeal to Obstetrics and Gynecology Clinic at Taksim Education and Research Hospital and Şişli Etfal Education and Research Hospital between the dates January 2000- December 2001 were evaluted with the age, smoking, pariety, socio economic status, number of partners and use of contraceptive methods. Socioeconomics status and smoking are found to be statisticaly signiftciant on Condyloma accuminate (p<0.05), after all the occupation, the number of partner, and the use of contraceptive methods are not found to be significiant (p>0.05). 15 patients of 107 cases had diagnosis of Condyloma Accuminate, and 2 patients of these 15 case were pregnant. The pregnant patients had excisions biopsy and other 13 patients had electrocautery. We concluded that the prevalence of condyloma accuminata should be investigated in the defined population.

Keywords:

Condylomata Acuminata, Pregnancy, Smoking, Vulvovaginitis, Warts, Sexually Transmitted Diseases, Viral, Papillomavirus Infections,

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Leung AK, Kellner JD, Davies HD. Genital infection with human papillomavirüs in adolescents. Adv Ther. 2005 May-Jun; 22(3): 187-97.
Koutsky LA, Galloway DA, Holmes KK. Epidemiology of genital human papillomavirüs infection. Epidemiol Rev. 1988; 10: 122-63.
H.Sciarra. Sexual and Reproductive Health and Rights .A Canadian Perspective. Vol 1 Ch:9 p: 1, 5, 6 JB. Lippincott Company Philadelphia 1992.
Zanotti KM, Belinson J. Update on the treatment of human papillomavirüs in infection. Cleve Clin J Med. 2002 Dec;69(12):948, 951-5, 956.
Campion MJ, Frankin EW 3rd, Stacy LD, Et al. Human papillomavirüs and anogenital neoplasia: a fersh look at the association. South Med J.1989. Jan;82 (1) :35 - 46.
Frenczy A. Epidemiology and clinical pathophysiology of condyloma accuminata. American Journal of Obstetrics and Gynecology.1995 Apr; 172 (4 Pt 2): 1246 - 50.
Schiffman M, Kjaer SK. Natural history of anogenital human papilloma virus infection and neoplasia. J Nathl Cancer Inst Monogr 2003;31: 14-19.
Jonathan S. Berek, MD. MMSC. Novae Gynecology. 13 edition. Part: 16, p: 475-477.
Kenneth DH. Clinical apperance and treatment strategies for human papillomavirüs : Agynecologic perspective. Am. J. Obstet. Gynecol.1995; 172 (4Pt2): 1340 -1343.
Koutsky L, Kiviat NB. Genital human papillomavirüs. In: Holmes K.K, Sparling P.F, Mardh PA, Lemon SM, Stamm WE, Piot P, Wasserheit JN. Sexually Transmitted Disease. Third edition. McGraw- Hill. 1999; 347- 59.
H.Sciarra, Vol:4 Ch:2 p:1- 18, JB. Lippincott Company Philadelphia 1992.
Zku WY, Leonardi C, Denneys NS. Polymerase chain reaction in detection of human papillomavirüs DNA anal types of condyloma accuminata: Chin. Med. J. Engl. 1993 Feb; 106(2): 141- 4.
Bertran P. Invasive squamous cell carsinoma in giant anorectai conyloma (Buschke Lowenstein tumor) Langenbecks. Arch. Uni. 1995; 380 (2): 115-8.
Kien AF. Management of conyloma accuminata with Alferon-N injection, interferon alfa- 3 (human leukocyte derived) Am. J. Obstet Gynecol.1995; 172: (4 Pt 2): 1359-1368.
Gall SA. Human papillomavirüs infection and therapy with interferon. Am. Obstet. Gynecol.1999; 172 (4Pt 2): 1355- 59.
Sante Canada, Lignes Directrice Canadienne pour les MTS. 1998. 18.Baggish MS, Dorsey JH, Adelson M. A ten- year experience treating cervical intraepithelial neoplasia with CO2 laser. Am J. Obstet Gynecol 1989 Jul; 161(1): 60- 8.
Chu N.R, Wu HB, Wu T. Immunotherapy of a human papillomavirüs type 16 E7- expressing tumour by administration of fusion protein comprimising Mycobacterium bovis bacille Calmette - Guerin (BCG) hsp65 and HPV -16 E7. Clinical and Experimental Immunology 121 ;216-25.
Dupin N. Genital warts. Clin Dermatol. 2004 Nov-Dec;22(6):481- 6.
Koutsky LA, Holmes KK, Critchlow CW, Etal. A cohort study of the risk of servical intraepithelial neoplasia grade 2 or 3 in relation to papillomavirüs infection. N England J Med 1992; 327: 1272-8.
Ertekin AA, Mungan E, Yergök ZG, Et al. Toplumumuzdaki HPV görülme insidansı ve tedavide triklorasetik asid. Jinekoloji Obstetrik Dergisi 1999; 196-99.
Sonnex C, Lacey CJ. The treatment of HPV lesions of the lower genital tract. Best Pract Res Clin Obstet Gynecol 2001 Oct; 15(5): 801-16.
Castellsague X, Munoz N. Cofactors in human papillomavirus carcinogenesis- role of parity, oral contraceptives, and tobacco smoking. J Nathl Cancer Inst Monogr 2003; 31: 20 - 28.
Butterworth CE Jr, Hatch KD, Macaluso M, et al. Folate deficiency and servical dysplasia. Journal of the Am. Medical Association. 1992 Jan 22- 29; 267 (4): 528 - 33.
Koffa M, Koumantakis E, Ergazaki M, etal. Association of herpesviriis infection with the development of genital cancer. Int J Cancer. 1995 Sep 27; 63(1): 58- 62.
Dede M, Dilek S. HPV İnfeksiyonu ve Genital Neoplazilerte İlişkisi; Journal of Clinical Sciences and Doctor. 2002. Volume:8 Number:1
Yenen MC, Baser I. Human Papilloma virüs Enfeksiyonlarında Yaklaşım ve Tedavi Yöntemleri; Journal of Clinical Sciences and Doctor. 2002. Vo!ume:8 N.umber:1.
Hagensee ME, Slavinsky J 3rd, Gaffga CM, Et al. Seroprevalence of human papillomavirus type 16 in pregnant women. Obstet Gynecol. 1999 Nov; 94(5 Pt 1): 653 - 8.
Tenti P, Zappatore R, Migliore P, Et al. Perinatal transmision of human papillomavîrüs from gravidas with latent infections. Obstet Gynecol. 1999; 93: 475.
Manns A, Strickler HD, Wiktor SZ, Et al: Low incidence of human papillomavirus type 16 antibody seroconversion in young children. Pediatr infect Dis J. 1999; 18: 833.
Tseng CJ, Liang CC, Soong YK, Et al: Perinatal transmission of human papillomavirus in infants: Relationship between infection rate and mode of delivery.Obstet Gynecol. 1998Jan; 91 (1): 92 - 6
Takac S, CO2 lazer and verruca vulgaris. Med Pregl. 2000 Jul- Aug; 53 (7- 8): 389 - 93.
Friedman - Kien AE, Eron LJ, Conant M, et al. Natural interferon alpha for treatment of acuminata. JAMA. 1988 Jan 22-29;259(4): 533-8.
Wright TC Jr, Richard RM, Ferencyz etal. Comparision of specimens removed by CO2 laser conization and the loop electrosurgical excision procedure. Obstet Gynecol. 1992 Jan;79 (1): 147 - 53.
American College of Obstetricians and Gynecologist: Genital human papillomavirus infections. Technical Bulletin No: 193 June 1994.
National guideline for the management of anogenital warts. Clinical Effectiveness Group (Association for Genitourinary Medicine and the Medical Society fort the Study of Venereal Diseases) SexTransm Infect 1999; 75(suppl 1): 71 - 5.
Gay C, Terzibachian JJ, Gabelle C, Et al. Carbon dioxide laser vaporization of genital condyloma in pregnancy. Gynecol Obstet Fertil. 2003 Mar; 31 (3): 214-9.