RSVP Montgomery

Risky Business

MARCH/APRIL 2017

Dr. Brian Richardson
What do Las Vegas, cancer and duct tape have in common? We’ve all heard the saying, Dzwhat happens in Vegas, stays in Vegas—well, except for herpes, and that stays with you foreverdz! Unfortunately, this is true. There are certain sexually transmitted infections (STIs) that once you become infected, you may never actuallyever rid yourself of the infection. HSV, or herpes simplex virus, certainly is an annoying and embarrassing problem, but there is another virus that is more common and can even put your life at risk. Human Papilloma Virus, otherwise known as HPV, is one of the most common STIs in our country. In fact, it is estimated that almost 80% of sexually active individuals have been exposed to this virus. 79 million Americans are currently infected and about 14 million new patients are infected per year. There certainly is some embarrassment when you come to the awareness that you have genital warts, but think about the fact that this virus is also one of the contributing factors for developing cervical cancer and possibly head and neck cancer. 

I hear a lot of stories in my field of specialty, and I can recall one particular story I heard when I was in residency about how one of my male patients believed he had contracted genital warts. A young man came into my clinic after the startling discovery that he had something abnormal that looked like cauliflower growing around his privates. Obviously, this caused a great deal of concern, and he was in a panic to have this evaluated and treated. He explained that while he was on a tripina foreign country, he had a free afternoon and decided to go relax and treat himself to a massage. There was no mention of any aberrant behavior, but he explained that after he returned home, he noticed some unsightly warts in an unmentioned part of his body. I probed him further about the massage, as well as other aspects of his sexual life, only to have him profess he was a virgin. His best explanation was that the towel that was issued to him at the massage parlor was certainly the culprit to his infection. I treated him. 
Myths are common, when it comes to STIs and especially when it comes to how one may become infected. Currently, there is no convincing scientific data demonstrating a person could be exposed to warts in the absence of sexual contact.The virus lives on the skin and the mucous membranes of the genitals and it patiently awaits contact with someone in order to share itself with the next unknowing victim. We hear those tales of transmission from toilet seats, towels, clothes, and many other methods, but the science just doesn’t back up those claims. 
Condoms are about 98% effective when used for birth control, and are very effective for prevention of most other types of sexually transmitted infections. However, when it comes to genital warts, the condom is only effective if it covers the infected skin. So, if you find yourself in an engaging act with a stranger, you might consider a flashlight and a magnifying glass prior to making any real contact. If your partner looks at you as if you had lost your mind, just remind them you are not in Vegas!
Now, I do want to make an important point here, and that is the fact that the sudden appearance of genital warts does not necessarily imply that your mate has recently engaged in risky relations outside of your current committed relationship. Once a person is exposed to HPV, the virus may just lie dormant on the skin for years before showing any symptoms. Our immune systems are very good at suppressing these types of chronic viral infections. The virus may become active in times of stress, illness, poor nutrition, or it might just surprise you one day and show up like an unwanted guest. 
Outside of the unsightly appearance of warts, certain strands of HPV have been strongly linked to the development of cancer, specifically cervical cancer. The really scary issue here is that the strands of HPV that increase the risk of cancer, actually do not cause warts. So, the first symptom of exposure to HPV could be an abnormal PAP smear. The virus produces changes in the normal cells of the cervix and leads to the transformation and mutation of those cells to form a potentially life threatening cancer. This lingering consequence is what led to the creation of the HPV vaccination. The vaccination is most effective in the prevention of HPV inoculation, and only recommended in the non-sexually active patient. 
So, we have seen how Vegas and cancer can be related to HPV, but what about duct tape? If I ended this article right now... I’m sure some of you would wonder what about the connection. When I grew up, duct tape could fix anything, including broken pipes, boxes, overactive mouths and the list goes on and on. One interesting usage of duct tape has been as a home remedy for genital warts. Based on the Google medical journal, duct tape can be placed on genital warts and left in place over the course of a couple days. Thereafter, the miracle tape is removed and Dzvoiladz—the warts are gone. As I thought about this method, I also realized that someone has to be really committed to this form of medicine and perhaps the consequence of not bathing during that period of time. The approved medical treatment of warts would include topical therapy, laser ablation and sometimes excision of the warts if they are very large. Regardless if the warts are completely removed or not, there is always the possibility they could return- refer back to the old Vegas saying. Routine PAP smears are an absolute MUST in the female sexually active patient. There is no approved blood test for men or women to verify HPV status or infection. So, if someone tells you they have been tested for HPV and are Dzclean,dz you may want to get some of that duct tape and put it on their mouth to keep them from telling you another lie! 
An ounce of prevention may be worth a pound of gold, and that same ounce may save you the embarrassment of unsightly warts and also save your life.
Dr. Brian Richardson is a urologist and chief of robotics and minimally invasive surgery at Jackson Hospital and Clinic.

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