A Case Series on Integrated Management of Anal Condyloma Acuminata

Abstract

Anal Condyloma acuminata is a viral disease caused by Human Papilloma Virus (HPV) which is distinct from virus of the common wart. It is usually associated to other veneral diseases and immune-compromised state. Certain strains of HPV are associated to dysplasia and progression to cancer usually squamous cell carcinoma of the anus. Patient usually present with mass per anum, itching and false odour rarely, relentless growth results in giant condylomata (Buschke Löwenstein tumour), which may obliterate the anal orifice. Method: Five patients of anal condyloma acuminata were managed by excision with electrocauterization and the excised masses were sent for histopathological examination to rule out any malignancy. In the post-operative period dressing was done with Jatyadi Taila and also Ayurvedic oral medicines were prescribed to enhance wound healing. Result: All the patients were cured without recurrences till the date. No patients had significant post-operative adverse events. Histopathological examination turned out to be non-malignant for all the patients. The treatment was well tolerated and was affordable to all the patients. Discussion: There are various methods for managing condyloma acuminata, out of which electrocoagulation is considered as best strategy of management where first or at most second degree of burn is created. For larger mass, base can be transfixed and ligated using Ksharasutra which sloughs on its own as a result of vessels strangulation. Post-operative care should be done efficiently to enhance timely healing and prevent recurrences. Immune-compromised state, sexual history should always be taken into consideration and malignancy should always be ruled out.