What to do about male genital herpes? Treatment of male genital herpes

Genital ejaculation has a certain incubation period. At the beginning, there is basically no feeling, no pain or itching, and the rash is not very obvious, so most patients cannot detect it in time. However, if genital warts can be discovered in time, early treatment is necessary, which is faster and more thorough. Once genital warts grow larger and show a tendency to spread, it will be more difficult to treat. So what are the treatments for genital warts in men?

Causes

Human papillomavirus infection in humans.

Clinical manifestations

This disease often has no subjective symptoms, and some patients may experience local pain or itching. The basic lesions initially appear as small, light red bumps of varying sizes, distributed singly or in clusters, moist and soft, with nipple-like, cockscomb-shaped or cauliflower-like protrusions, red or dirty gray, often with pedicles at the roots, and are prone to erosion and exudation, and are easily bleeding when touched. Purulent secretions often accumulate in the cracks of skin lesions, causing a foul odor, and secondary infection is often caused by scratching. Due to constant exposure to local moisture and chronic irritation, they tend to grow rapidly. This disease often has no subjective symptoms, and some patients may experience local pain or itching. Occasionally it may transform into squamous cell carcinoma.

The most common sites of this disease are the coronal sulcus, glans penis, foreskin, frenulum of foreskin, urethral orifice, urethra, penis body and root, perineum, around and inside the anus (rectum), groin, etc.

The incubation period of genital warts in men is 3 weeks to 8 months, with an average of 3 months. It is more common in sexually active young and middle-aged men, with the peak age of onset being 20 to 25 years old. Male patients with an average disease course of 3 to 5 months develop the disease shortly after sexual contact; while male patients with an average disease course of 12 months may not develop the disease in their sexual contacts. Subclinical infection refers to lesions that cannot be identified by the naked eye clinically, but when 3% to 5% acetic acid solution is applied topically or applied wet for 5 to 10 minutes, the human papillomavirus (HPV) infected area can be seen to turn white, the so-called "acetic acid whitening phenomenon."

treat

The treatment of male genital warts must adopt comprehensive treatment: treating the predisposing factors (phimosis, gonorrhea), improving the body's immunity, and applying antiviral drugs. Generally, as long as you adhere to standardized comprehensive treatment, you can be cured. Physical therapy can also be used, such as laser, electrocautery, and freezing. First of all, we need to enhance the body's immunity.

1. Surgery

Treatment causes: foreskin is too long, gonorrhea. For single, small warts, surgical removal can be performed; for giant condyloma acuminatum, Mohs surgery can be used for removal. During surgery, frozen sections are used to check whether the lesion has been removed completely.

2. Cryotherapy

Using liquid nitrogen at a low temperature of -196℃, the freezing method is used to treat genital warts, promoting the necrosis and shedding of wart tissue. This method is suitable for warts with small number and small area. 1 to 2 treatments can be performed, with an interval of one week.

3. Laser treatment

Genital warts are usually treated with a CO2 laser, which is a burning method. This treatment is most suitable for warts on the penis or around the anus. Single or a small number of multiple warts can be treated once, while multiple or large warts can be treated 2 to 3 times, with an interval of one week between treatments.

4. Electrocautery

Use high-frequency electroacupuncture or electrosurgery to remove warts. This therapy is suitable for warts with a small number and small area.

5. Microwave therapy

Microwave surgery is used for treatment with lidocaine local anesthesia. The tip of the rod-shaped radiation probe is inserted into the condyloma acuminata directly to the base of the wart. When the wart becomes smaller, darker in color, and changes from soft to hard, thermal radiation coagulation is complete and the probe can be removed. Coagulated lesions can be removed with forceps. To prevent recurrence, the remaining base can be coagulated again.

6. Beta-ray therapy

This method has good efficacy, is painless, non-destructive, has few side effects, and has a low recurrence rate, and is worth promoting in clinical practice.

7. Drug therapy

(1) Podophyllum resin This treatment is suitable for warts in moist areas, such as warts on the glans penis caused by excessive foreskin and uncircumcised males. Apply 20% podophyllum resin tincture to the lesions, or use an oily antibacterial ointment to protect the normal skin or mucous membrane around the lesions before applying the medicine. 4 to 6 hours after application, wash with 30% boric acid water or soapy water. Repeat the dose after 3 days if necessary. This drug is the first choice for treating this disease abroad and can usually cure the disease with one use.

(2) Virus-killing drugs: Currently, they are mainly based on macrocyclic triterpenes. The main therapeutic principle is that macrocyclic triterpenes can kill HPV viruses hidden in the skin and mucous membranes. This type of drug treatment has a long course of treatment, and the warts fall off more slowly, but the recurrence rate is very low.

(3) Corrosive agents or disinfectants: 30% to 50% trichloroacetic acid, saturated dichloroacetic acid, or 18% peracetic acid. Use 10% salicylic acid, glacial acetic acid or 100ml mixed solution of 40% formaldehyde, 2% liquefied phenol, and 75% ethanol distilled water, and apply it topically for the glans penis and perianal warts, once a day or every other day, the effect is very good. The disinfectant can be applied externally with 20% iodine tincture, or 2.5% to 5% iodine tincture can be injected into the base of the wart, or applied externally with chlorhexidine, or 0.1% to 0.2% can be applied externally. The latter needs to be combined with systemic therapy.

(4) Anticancer drugs ① 5-Fluorouracil (5-Fu) 2.5% to 5% fluorouracil wet compress is used to treat penile and perianal condyloma acuminatum. Polyethylene glycol can also be used as a matrix, and 5-Fu powder accounting for 5% of its dry matter can be added to make suppositories to treat male urethral condyloma acuminatum. 5-Fu can also be used for basal injection, and more can be injected in batches. ②Thiotepa is mainly used for intraurethral condyloma acuminatum that has failed to be treated with 5-Fu. Its side effects include urethritis. You can also use 10 mg of this product added to 10 ml of normal saline to soak the affected area to treat male penis and glans coronal sulcus warts. It is mainly used for patients with residual warts or recurrences after treatment with other methods. You can also dilute this solution twice and soak the local area to prevent recurrence. ③ Colchicine can be applied externally in a 2% to 8% saline solution to treat penile warts. Superficial erosion may occur after application.