The etiology of vulvar cancer is still unknown. At present, it is considered that human papillomavirus (HPV) is the main cause, but HPV-negative vulvar cancer is related to vulvar leukoplakia, vulvar atrophy, vulvar condyloma acuminatum and other sexually transmitted diseases such as syphilis and lymphogranuloma.
The main symptom is vulvar nodule, which is often accompanied by pain and itching. Most patients first have long-term vulvar itching, and after many years, papules, vulvar nodules or small ulcers appear locally, which will not heal for a long time. Some patients are accompanied by vulvar leukoplakia. When the tumor is adjacent to or invades the urethra, frequent urination, painful urination, burning sensation of urination and dysuria may occur. In the late stage, it is characterized by ulcer or irregular papillary or cauliflower-like mass, and purulent secretion is often found in the lesion site. Lesions can also spread to anus, rectum and bladder, and hard and immobile swollen lymph nodes can be felt in one or two groins.
Therapeutic methods 1, indications of radiotherapy
For patients with squamous cell carcinoma whose primary tumor is huge, deeply infiltrated, close to or involving urethra, vagina and anus, and it is difficult to resect, preoperative radiotherapy can shrink the tumor, improve the resection rate and preserve the function of adjacent organs.
The surgical margin is too close to the tumor to be easily removed.
Elderly patients or other reasons are not suitable for surgery.
Young patients with small primary cancer near the clitoris need to keep the clitoris.
Advanced vulvar cancer is treated by radiotherapy and surgery instead of pelvic organ resection, which is traumatic and unwilling to be accepted by patients.
Recurrent vulvar cancer that is difficult to resect after operation.
2. Surgical treatment of vulvar cancer
Generally speaking, surgical resection can be used to treat this disease, and its surgical methods and scope include the following points:
Simple vulvar resection includes partial clitoris, bilateral labia majora and posterior commissure of labia minora, and the cutting edge reaches the outer edge of labia majora fold. The depth of subcutaneous fat is 2cm, and the perineum and vagina are preserved.
The upper boundary of radical excision of vulva is from pubic mound, and the lower boundary is behind perineum. The skin margins on both sides of labia majora fold are 3cm away from the tumor, and the internal incision includes excision of 1cm vaginal wall. The adductor fascia on both sides, the base of which reaches the pubic fascia (upper part) and the thickness of skin graft.
The scope of local radical excision of vulva includes normal skin and subcutaneous adipose tissue 3cm around the cancer focus. Under the principle of peripheral excision of normal tissue 1cm or more, urethra or anus will not be damaged. Partial radical vulvar surgery can be unilateral vulvar excision, anterior vulvar excision or posterior vulvar excision. However, partial excision of vulva must ensure that the local cancer focus is completely removed, and the depth and distance from the periphery of the cancer focus are the same as those of radical excision.
The inguinal lymph nodes were dissected 3cm from the medial side of the anterior superior iliac spine, passed through the beating point of the abdominal artery at the midpoint of the inguinal ligament, and reached the vertical longitudinal incision at the tip of femoral triangle. The thickness of skin graft is 0.5 cm, covering the surface of external anterior superior iliac spine and sartorius muscle. The femoral canal was opened on the surface of medial pubic tubercle and adductor muscle, and the soft tissue lymph nodes on the surface of femoral vein and adductor muscle were removed, including Cloguet lymph nodes in femoral canal, and the great saphenous vein was ligated at high position.
If pelvic retroperitoneal lymphadenectomy does not need to remove pelvic organs, it should be performed outside the peritoneum, and its resection scope is the same as that of radical hysterectomy for cervical cancer.
After partial urethrotomy, the specimens were separated downward from pubic symphysis and pubic arch, and the clitoris foot was treated. After the urethra was 2cm away from the pubic arch, partial urethrotomy was performed with the support of metal catheterization.
Total urethroplasty with bladder muscle flap.
If the vulva involves the triangular area of bladder after anterior pelvic organ resection, total cystectomy is performed, and total hysterectomy plus anterior vaginal wall resection and urinary diversion are often used.
After pelvic organ resection, vulvar cancer involves anal canal, rectum or vagina-rectum diaphragm, and combined abdominoperineal resection of rectum or partial vaginal posterior wall is performed. Sigmoidostomy sometimes requires simultaneous hysterectomy and posterior vaginal wall resection.
3. Biotherapy
Surgery, radiotherapy and chemotherapy all have the shortcomings that vulvar cancer cannot be cured. Surgery can only remove local lesions, which is easy to metastasize and relapse. Chemotherapy and radiotherapy have great toxic and side effects, which easily cause patients to have symptoms such as nausea and vomiting, damage human immune function and seriously dampen patients' anti-cancer confidence.
In view of the disadvantages of surgical radiotherapy and chemotherapy, biological immunotherapy after vulvar cancer surgery can improve the functional state of the body and prevent metastasis and recurrence. Combined with radiotherapy and chemotherapy, it can improve the overall curative effect and reduce side effects, which is beneficial to the early recovery of surgical injury. Biological immunotherapy can be used as the main treatment for patients with advanced vulvar cancer who are not suitable for surgery and radiotherapy and chemotherapy. By increasing the number of immune cells in the body, symptoms can often be alleviated, the quality of life can be improved and the life span can be prolonged.
Prevention 1, develop good living habits, quit smoking and limit alcohol. Smoking, the World Health Organization predicts that if people stop smoking, the number of cancers in the world will decrease 1/3 in five years. Second, don't drink. Alcohol and tobacco are extremely acidic substances, and people who smoke and drink for a long time are prone to acidic constitution.
2. Don't eat too much salty and spicy food, and don't eat overheated, supercooled, expired or deteriorated food; People who are old and weak or have genetic diseases should eat some anti-cancer foods and alkaline foods with high alkali content to maintain a good mental state.
3, have a good attitude to deal with stress, work and rest, don't be too tired. It can be seen that stress is an important cause of cancer. Traditional Chinese medicine believes that stress leads to overwork and weakness, which leads to the decline of immune function, endocrine disorder and metabolic disorder, leading to the deposition of acidic substances in the body; Stress can also lead to mental stress, causing qi stagnation and blood stasis, toxic fire invagination and so on.
4, strengthen physical exercise, enhance physical fitness, and exercise more in the sun. Hyperhidrosis can excrete acidic substances in the body with sweat to avoid the formation of acidic physique.
5, life should be regular, people with irregular living habits, such as singing karaoke all night, playing mahjong, staying out at night and other irregular lives, will aggravate the acidification of the body and be prone to cancer. It is necessary to develop good living habits, maintain a weak alkaline constitution, and keep all kinds of cancer diseases away from yourself.
6, do not eat contaminated food, such as contaminated water, crops, poultry and fish eggs, moldy food, etc. Eat some green organic food to prevent diseases from entering the mouth.
Leukoplakia vulvae > > etiology 1, heredity
According to relevant statistics, about 5% ~ 15% of patients with vulvar leukoplakia are caused by genetic reasons. Hereditary leukoplakia vulvae is mostly atrophic, with a low onset age, which is more common in young girls under 15 years old.
2. Inflammation
Inflammation, such as trichomonal vaginitis, fungal vaginitis, cervical erosion, etc., causes leucorrhea increase and degeneration, which stimulates the vulva for a long time and leads to leukoplakia of vulva.
3. Personal hygiene
If women use unclean sanitary napkins and toilet paper in their daily life, it will lead to the breeding and spread of perineal bacteria. If you are allergic to chemical fiber substances, the vulva will be stimulated by infection, skin and mucosa will be damaged, redness, ulcers and degeneration will occur, and vulva leukoplakia may also be formed.
4, endocrine disorders
Endocrine system is a body fluid regulation system composed of endocrine glands and endocrine tissues in some organs, which acts on the target cells and adjacent cells of human body, thus regulating physiological activities such as metabolic process, organ function, growth and development, and maintaining the relative stability of the internal environment of the body.
Clinical manifestations in patients with vulvar leukoplakia, the symptoms of vulvar leukoplakia can usually be mild itching of vulva, which will gradually increase in the future, and some people even feel itchy, especially at night.
The symptoms of vulvar leukoplakia depend on different conditions. The general symptoms of vulvar leukoplakia are itching, cracks, ulcers, hyperplasia, thickening, roughness, hardening, desquamation, pus discharge or atrophy, adhesion and so on. The color of patients with vulvar leukoplakia can be creamy white, grayish white, pink white or black spots and leukoplakia. In addition, the most serious symptom of vulvar leukoplakia is itching.
Treatment 1, surgical treatment
In the past, it was thought that the malignant rate of the disease was high, so surgery was the main treatment in the past, but the postoperative recurrence rate was high, reaching more than 80%. There will be serious complications after operation, and the deformation of vulva scar will seriously affect the physical and mental health and sexual life of patients. There is still the possibility of recurrence after another operation.
2. Local freezing
Freezing can cause pain and burning sensation in patients, so freezing must be carried out under general or local anesthesia. After freezing, the local surface is red and swollen, which disappears one day, blisters may appear the next day, and the scab falls off six to seven days. The short-term effect of this method is good, but the recurrence rate is still high, which is equivalent to the long-term effect of vulvar resection.
3. Bohm infrared ray
General irradiation power 12 ~ 14W, irradiation distance 10 cm, vertical irradiation angle, irradiation time15 ~ 20min, once every day or every other day, with ten times as a course of treatment. After infrared irradiation, different adjuvant treatments can be used. However, this kind of therapy is slow to recover and needs several courses of treatment.
4. Laser therapy
Although laser therapy has the advantages of accurate operation, simple operation and little injury, the whole treatment process is long. After 5 courses of 10 ~ 15, the patients' skin gradually becomes soft and thin, and the skin pigment gradually turns pink. Some patients are prone to relapse after irradiation, so it is necessary to maintain irradiation.
Prevention 1. In daily life, you should wear loose underwear with good air permeability, mainly cotton products, and avoid wearing underwear with chemical fiber products such as acrylic fiber. This is one of the methods to prevent vulvar leukoplakia.
2. To prevent vulvar leukoplakia, the affected area should be kept dry, ventilated and cool;
3. Some women love cleanliness so much that they have the habit of cleaning their vulva once or several times a day. Here, we suggest that the female vulva can be cleaned 2-3 times a week because of its self-cleaning function. Don't use any detergent when cleaning, just wash with warm water to avoid overheating of the water temperature, which is also the focus of preventing vulvar leukoplakia.
4, prevention of vulvar leukoplakia in daily life should pay attention to adjust life pressure and emotions, and maintain an optimistic and cheerful mood. At this time, the patient's family members should actively cooperate and establish confidence in overcoming the disease.
5. It is very important to avoid sexual life and prevent vulvar leukoplakia during treatment.
Trichomonas vaginalis > > Etiology Trichomonas vaginalis vaginitis is caused by Trichomonas vaginalis, Trichomonas hominis and Trichomonas oral are parasitic in the urogenital system, intestine and mouth respectively, and Trichomonas vaginalis is is related to skin diseases, causing trichomonas vaginalis vaginitis. It is a parasitic disease, which is mainly transmitted through sexual intercourse and is contagious.
The clinical manifestations of most cases are asymptomatic. Women may feel unwell for 65,438+0 weeks or months, and then get better obviously due to menstruation or pregnancy. Vaginal mucosa is red and swollen, bright red, covered with patchy pseudomembrane, often accompanied by foam-like secretion, and has varying degrees of itching, and a few have burning sensation. Leucorrhea increases, turning yellow and green. Occasionally, frequent urination, urgency, dysuria and hematuria may occur, or abdominal pain, diarrhea, mucus stool or alveolar abscess and dental caries may occur. It often causes urethritis, cystitis and vestibular adenitis.
Treatment 1, vaginal medication: First of all, vaginitis can be treated with drugs, which can be used in vagina, and metronidazole vaginal effervescent tablets or metronidazole tablets can be used. Take medicine after cleaning vagina every night.
2, Chinese medicine external washing: you can also use Chinese medicine for treatment, with some Chinese herbal medicine decoction external washing, for some vulvitis, it is still very effective, I hope everyone can pay attention.
3. Change the pH of vagina: The pH suitable for trichomonas growth is 5.5 ~ 6, so washing vagina with chlorhexidine acetate solution can reduce the pH of vagina and inhibit the growth of trichomonas. So as to achieve the effect of treating trichomonal vaginitis.
4, general treatment: during the treatment of trichomonal vaginitis, keep the vulva clean to prevent secondary bacterial infection, clean the vulva every day, change underwear, disinfection; Do not eat spicy food or drink alcohol in acute stage; Sexual life is forbidden, and spouses with trichomonal vaginitis need to be treated together.
5, oral medication: because trichomonas is not only stored in the vagina, but also hidden in the lower urinary tract, vestibular glands, cervical glands, this situation can not be treated simply by local medication, so oral medication is also needed. At the same time, when men receive trichomonal vaginitis treatment together, they mainly rely on drugs. And consult a doctor before taking the medicine.
Prevention 1, do gynecological examination every year: don't be ashamed to treat trichomonal vaginitis. Many female friends lack self-care awareness and rarely take the initiative to go to the hospital for gynecological examination. Even if they know that they have gynecological diseases, some may think that gynecological diseases are minor illnesses, and they can go to the hospital or not as long as they do not affect their work and life. There are also some women who remain silent about gynecological diseases, and always feel that gynecological diseases are very embarrassing and quite private diseases, which make the inflammation unable to be cured in time, and the condition is delayed and spread. These are all incorrect practices. It is best for female friends to go to the hospital for a gynecological examination every year, so as to achieve early treatment and early prevention.
2. Pay attention to the hygiene of public places: try not to use public bathtubs at ordinary times, and it is best not to use toilets when going to the toilet. Don't go swimming in the swimming pool without strict disinfection. Try to use your own bath towel when you go out.
3. Healthy women should not use all kinds of vaginal lotions indiscriminately: The reproductive organs of healthy women have relatively complete self-defense functions in anatomy, physiology and biochemistry, and can defend against infections caused by external factors. At present, there are many vaginal lotions aimed at preventing and treating gynecological diseases. Although these lotions are effective in treating gynecological diseases such as vaginitis, for healthy women, long-term use will interfere with the ecological balance in their vagina, inhibit the growth of beneficial bacteria, and lead to mold. What is even more frightening is that foreign pathogenic microorganisms may infect the pelvic cavity during washing, leading to gynecological diseases such as chronic pelvic inflammatory disease. Healthy women keep their vulva clean, as long as they clean their vulva with clear water every day, change their underwear every day, and dry them in the sun for disinfection. They don't wear underwear made of synthetic fiber fabrics, so as to form a good habit of washing their hands after defecation.
4, pay attention to menstrual hygiene: pay attention to menstrual hygiene, once infected with trichomonal vaginitis, measures should be taken to prevent transmission to others, underwear, sheets, washing towels and so on. It should be boiled and disinfected for 5 ~ 10 minutes, and dried in the sun. Washing utensils should be used separately from bedding, such as towels and bathtubs. , and pay attention to underwear, sheets and other personal items in time to boil disinfection and sun exposure. After cure, avoid repeated infection.
5. Develop good living habits: In order to prevent trichomonal vulvitis, female friends should develop good living habits in their daily lives, and try not to eat spicy and irritating food in their daily diet, but should eat more fresh fruits and vegetables. And make sure you get enough sleep every day, avoid staying up late for a long time, and don't drink or smoke. In addition, after getting trichomonal vaginitis, we should avoid spicy food. Common spicy foods such as Chili and curry and hot foods such as mutton, dog meat and longan should be eaten less, which can aggravate symptoms. Avoid eating seafood, shrimp, crabs, shellfish and other seafood and sweet and greasy food; Eat more light food.
Mycotic vulvitis > > etiology 1. Inadequate hygiene work: Most women do not pay attention to their hygiene work, which leads to vulvar inflammation, such as using unclean toilet paper and sanitary napkins. Mix pots and washing utensils with others. Often sit in public bathrooms or swimming pools. May lead to vulvitis in women.
2, improper use of antibiotics: most women are due to abuse of antibiotics or long-term use of antibiotics or lotion, which may break the balance between bacteria, but make women vulnerable to vulvitis.
3. One spouse has Candida albicans, which can be transmitted to the other spouse through sexual life.
4, the body's resistance is reduced: it will multiply in a suitable environment, causing fungal vaginitis and vulvitis. For example, oral adrenocortical hormone will reduce the body's immunity or change glucose metabolism.
5, vulvar injury: can promote the occurrence of vulvovaginal candidiasis and vaginitis.
Clinical manifestations The clinical symptoms of mycotic vulvitis are itching, burning sensation and dysuria (complicated with urethritis). Many women complain of pain in sexual intercourse, swelling and edema around vulva, and various changes in epidermis: shallow blisters and papules may appear and appear in groups; Eczema-like erosion can also be formed, which is confined to vulva or extends to perineum, perianal region, femoral reproductive folds and the inner thigh. The appearance is completely similar to acute or subacute eczema, the mucosa between labia and clitoris is thickened, and the skin surface in contact with each other is flushed and eroded. Individual cases can cause tiny white pustules, and in severe cases, ulcers, pain in the affected area and local lymphadenitis occur.
Mild mycotic vaginitis is characterized by pruritus of vulva and vagina, burning sensation, increased leucorrhea, and dysuria. In addition, redness and edema often appear around the vulva, and the epidermis has various changes. The incidence of fungal vaginitis often appears leucorrhea, vulva and vagina burning itching, vulva dysuria, vulva erythema and so on. In particular, the itching symptoms of mycotic vaginitis in pregnancy are particularly serious, even fidgeting, unbearable pain, frequent urination, dysuria, sexual pain and other symptoms may occur. In addition, about 10% of women and 30% of pregnant women are mold carriers, but they have no clinical manifestations.
Food to prevent fungal vulvitis should be eaten.
1, should eat more light food, eat more nutritious food, mainly high protein and low fat.
2, drink more yogurt, yogurt can prevent gynecological inflammation, which is a very good food for women.
3, if you have itching symptoms, you can eat some amaranth, cabbage, mustard, taro, kelp, seaweed, chicken blood, snake meat and other foods.
4, symptoms of increased leucorrhea can eat more millet, tofu, leeks, ginkgo lentils, lotus seeds, walnuts and other foods.
5. Eat more fruits and vegetables, such as bananas, sweet potatoes and celery. To help the disease.
Taboo food for mycotic vulvitis
1, patients had better not drink alcohol. Many women have the habit of drinking, but alcohol is a warm and stimulating food. Drinking it will aggravate the body's dampness and heat, and it will not help the improvement of the condition but will recur.
2. Do not eat spicy foods such as peppers, peppers, raw onions, raw garlic, white wine and drinks.
3, fried, moldy, greasy, pickled these foods patients had better not eat, it is not helpful to the condition.
4, don't eat too sweet food, because these foods will increase the moisture of women's bodies and hinder treatment. This kind of food includes: candy, cream cake, eight-treasure rice, glutinous rice cake and so on.
5, seafood hair is also a taboo for patients with fungal vulvitis. Marine fish, crabs, shrimps, clams, clams and other foods are not allowed to be eaten by patients. These foods are not conducive to the regression of inflammation, resulting in poor curative effect.
Ulcer of vulva > > Etiology The vulva is adjacent to the urethral orifice and anus, and is often polluted by leucorrhea, menstrual blood, urine and feces. The estrogen level of infants and menopausal women is low, and the vulva skin and mucosa are fragile. Women of childbearing age have frequent sexual life; Wearing tight chemical fiber underwear and sanitary napkins makes local air permeability poor, which can lead to pathogen infection and disease damage.
Pathogens that cause vulvar ulcers include bacteria, fungi and viruses. The following diseases can cause vulvar ulcers.
1, syphilis. It mainly occurs in primary syphilis, which is called chancre. Skin lesions usually occur in the genital area, but also in the lips, pharynx, tongue and breast. Generally painless ulcer with a diameter of 1-2cm. The surface of the ulcer is clean with a small amount of exudate on it. The ulcer can disappear naturally within 3-8 weeks without treatment, leaving no trace or only slight atrophy and pigmentation after recovery.
2, genital herpes. Multiple papules, small blisters or pustules first appeared in the genital area, and then evolved into erosion and ulcer. Skin lesions have itching and pain, and ulcers generally subside in about 3-4 weeks. After recovery, new injuries may occur or recur in the same place.
3. Groin granuloma. Skin lesions often occur in the vulva. At the initial stage, the skin lesions are hard subcutaneous nodules, and then a well-defined proliferative granulomatous ulcer is formed, which has a foul smell, the edges are rolled up, and the central beef is red, which is easy to bleed and painless. There is pus on the surface of the ulcer, and many satellite ulcers can appear around it.
4. Fixed drug rash. Skin lesions can be painful erythema, blisters, erosion or ulcers, usually single or multiple. There is a clear history of medication, and it appears in the same part after each medication, especially at the junction of skin and mucosa such as lips, glans penis and anus, and similar lesions can also appear in other parts of the body.
5. Behcet's disease. Behcet's disease is characterized by recurrent oral ulcers and is a systemic immune disease. The genital ulcer of Behcet's disease is more specific. Female genital ulcer can occur in labia majora or vaginal wall, but the symptoms vary in severity and may even be asymptomatic, which needs gynecological examination to be found. According to reports, many pudendal ulcers of Behcet's disease are often misdiagnosed as sexually transmitted diseases and cannot be cured for a long time. If such patients are accompanied by frequent oral ulcers, it is probably not sexually transmitted diseases, but Behcet's disease.
6. Acute vulvar ulcer. Most of them happen to young women. Sudden onset, starting from vulvar ulcer, usually occurs in the inner side of labia majora and labia minora and vestibular mucosa. Ulcer size varies, 1-2cm. Severe ulcer has large area, deep lesion, surface covered with necrotic membrane-like substance, and local pain is obvious. The course of the disease is usually 3-4 weeks, and there are still scars after recovery.
Clinical manifestations: 1, skin and mucosa ulceration, defect, peripheral congestion, edema and exudate at the bottom of ulcer.
2, local itching, pain, burning sensation.
3, inguinal lymph nodes can be swollen.
4. There may be systemic symptoms such as fever and fatigue or disease manifestations in other parts of the body.
5, vulvar ulcers are often related to sexually transmitted diseases, and repeated attacks should be alert to diabetes.
Processing method: 1. Etiological treatment: Specific systemic and local treatment for different causes. Drug treatment includes antifungal, antiviral, anti-tuberculosis, anti-syphilis and so on.
2, local treatment: keep the vulva clean and dry, with the right amount of liquid medicine sitz bath. Apply the medicine to the skin injury. Dyclonine cream (fungal infection) and acyclovir cream (viral infection) were selected for different pathogens. Local physical therapy can help cure some vulvar ulcers.
Note: The key to the treatment of vulvar ulcer is to identify the cause. At the same time of active treatment, try to reduce the friction of lesions and keep the vulva clean and dry. Some patients with severe symptoms should also stay in bed and change medicine regularly to facilitate the healing of skin lesions.
Condyloma Acuminatum >> Etiology of unhealthy behavior
Most sexually transmitted diseases are caused by unhealthy behaviors. If women have multiple sexual partners, they are likely to get condyloma acuminatum. Women who have sex when they are young are also very likely to suffer from condyloma acuminatum. If they are very young, it will have a serious impact on their future fertility.
Immune hypofunction
Patients with low immune function are easily infected by some diseases, such as lupus erythematosus, malignant tumor, kidney transplantation and glucocorticoid application. The incidence and recurrence rate of condyloma acuminatum will increase exponentially, and warts are also very large and difficult to treat. For patients with low immune function, we must pay attention to protecting our health and take various preventive measures in our lives to prevent condyloma acuminatum.
Other sexually transmitted diseases
Other sexually transmitted diseases are also very likely to cause condyloma acuminatum in women. Gonorrhea, trichomoniasis, Samui, fungal infection and other diseases. , will destroy the mucosal protective barrier, reduce the ability to resist these diseases, make the genital local environment moist, make the virus easy to breed, and thus lead to condyloma acuminatum in women.
Clinical manifestations: Female patients are greatly harmed by condyloma acuminatum. When condyloma acuminatum occurs in vulva, the most typical symptom is that there are very few reddish, very soft and tiny papules at the beginning of the disease, and then they will become more and more changeable with the development of the disease, and the papules will merge or overlap, and the surface looks very uneven, like warts. Because some parts are very hot and humid and have chronic irritation, warts will grow rapidly and eventually become different shapes, such as papilla, cauliflower, cockscomb or mushroom. These warts are very soft in nature and easy to bleed when touched.
During the onset of some patients with condyloma acuminatum, the secretion produced is white, dirty or red, which permeates the surface of the wart and brings great inconvenience to the life of female patients. The root of wart body is very narrow, pedicled, and the surface is also very moist, often exudation, erosion and skin lesions. At the same time, there is very pus secretion pushing into the gap, so it is very easy to be infected by bacteria and has a very strong stench. The symptoms that women themselves feel are that the affected area is very itchy, burning or oppressive.
Treatment, surgical treatment
For single condyloma with small area, it can be surgically removed; For the huge condyloma acuminatum, Mohs operation can be used to remove it, and frozen sections are used to check whether the injury is removed cleanly during the operation.
Crying therapy
Low temperature liquid nitrogen (-196℃) was used to treat condyloma acuminatum by pressure freezing to promote the necrosis and shedding of wart tissue. This method is suitable for condyloma acuminatum with a small number and area, and it is feasible to treat it 1 ~ 2 times with an interval of one week.
Laser therapy
CO2 laser is usually used to treat condyloma acuminatum by cauterization. This therapy is most suitable for condyloma acuminatum in vulva, penis or perianal region. Single or a small number of multiple condyloma can be treated once, and multiple or large condyloma can be treated for 2 ~ 3 times, and the interval is usually one week.
Electrocautery therapy
High-frequency electroacupuncture or electrotome was used to remove condyloma acuminatum. Methods: Electrocautery was performed after local anesthesia. This therapy is suitable for condyloma acuminatum with small quantity and area.
Microwave therapy
Using microwave surgical treatment machine and lidocaine local anesthesia, insert the tip of the rod-shaped radiation probe into the base of the wart, and when the wart becomes smaller, darker in color and turns from soft to hard, complete radiation curing, and then pull out the probe. Coagulated lesions can be removed with tweezers. In order to prevent recurrence, the remaining base part can be solidified again.
β -ray therapy
We have achieved satisfactory results in the treatment of condyloma acuminatum with β-ray. This method has the advantages of high curative effect, no pain, no injury, few side effects and low recurrence rate, which is worth popularizing in clinic.
drug therapy
This therapy is suitable for condyloma acuminatum in damp parts, such as glans penis and perineum, where the foreskin is too long and not circumcised. But condyloma acuminatum can't be treated with podophyllum. Apply 20% turpentine tincture to the lesion or before taking the medicine, first protect normal skin or mucosa around the lesion with oily antibacterial ointment, then apply the medicine, rinse it with 30% boric acid water or soapy water for 4-6 hours after use, and repeat the medicine after 3 days if necessary. This medicine is the first choice to treat this disease abroad, and it can be cured in one time. However, it has many disadvantages, causing great damage to tissues, and improper use will cause local ulcers. Toxic, mainly manifested as nausea, intestinal obstruction, leukopenia and thrombocytopenia, tachycardia, urinary incontinence or oliguria, so it must be used with caution. When the above reaction is found, the drug should be stopped immediately.
Antiviral drugs can be externally applied with 5% phthalamide cream or 0.25% herpetin ointment twice a day. Acyclovir is taken orally, 5 times a day, or externally applied ointment. Interferon-α was injected with 3 million units every day for 5 days every week. Or inject interferon at the base of the wart twice a week. 2 ~ 3 weeks, the main side effect is influenza-like syndrome, and the side effects of local medication are less and lighter.
Corrosive or disinfectant is usually 30% ~ 50% trichloroacetic acid or saturated dichloroacetic acid, or 18% peracetic acid. The mixed solution of 10% salicylic acid glacial acetic acid or 40% formaldehyde, 2% liquefied phenol and 75% ethanol distilled water is applied to the glans penis and perianal condyloma once a day or every other day, and the effect is very good. Disinfectant can be applied externally with 20% tincture of iodine, 2.5% ~ 5% tincture of iodine can be injected at the base of wart, and it can also be applied externally with bromogeramine or 0. 1% ~ 0.2%, and the latter needs to be combined with systemic treatment.
Prevention 1, resolutely put an end to sexual promiscuity: 60% of patients with condyloma acuminatum are infected through sexual contact. One member of the family gets sick from society, but also spreads it to his spouse through sexual life, and may spread it to other family members through close life contact, which not only brings physical pain, but also causes family discord and mental stress. Therefore, improving sexual morality and not having sex outside marriage is an important aspect to prevent condyloma acuminatum.
2. Prevent contact infection: Don't use other people's underwear, swimsuits and bathtubs; Don't wash basins and pools in public baths; Advocate shower; Don't take a shower directly in the chair after taking a shower. Try to use squatting toilets in public toilets; Wash your hands with soap before going to the toilet; Don't swim in a swimming pool with high density and poor disinfection.
3. Pay attention to personal hygiene: clean the vulva every day, change underwear, and clean personal underwear separately. Even among family members, one person should share a washbasin and towel.
4. Sexual life should be forbidden after the spouse is ill. If the spouse only receives physical therapy, although the condyloma acuminatum visible in the vulva disappears, the patient still carries human papillomavirus, and should also receive comprehensive treatment of oral drugs and external washing drugs, and review after treatment. If you have sex during this period, you can use condoms for protection.
5. Pregnant women with condyloma acuminatum can choose cesarean section in order to avoid infecting the fetus during delivery. Don't bathe in the same basin with your baby after childbirth.