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Anal infections by human papillomavirus, criotherapy, and cryoimunology

Genital warts caused by human papillomavirus (HPV) are a common problem in clinical practice of colorectal surgeons. There are several therapeutic options, although, there is not a gold standard for the treatment of condilomas. Among them, we could mention cryotherapy, which is an effective method, despite having little use. The destructive effect of cryotherapy is through direct cellular injury, which is provoked by cold, and tissue anoxia, due microcirculatory changes. Among the method advantages, we could relate safety; simplicity of application; use inside and outside the anal canal, and during pregnancy; and mild local discomfort, not requiring anesthesia for its application. The most commonly used cryogenic agents are liquid nitrogen and more recently dimethylether-propane. An additional advantage is observed in the treatment of neoplasias and its precursors. It is postulated that freezing would induce an anti-tumor immune response, consequent to the mechanism of tissue injury, exposing a large amount of intracellular antigens to macrophages and dendritic cells. However, the literature still lacks studies specifically addressing this issue, especially in coloproctology. Anyway, we could say that cryotherapy is an effective, safe, comfortable, and practical method to treat anogenital warts induced by the HPV.

papillomavirus infections; condylomata acuminata; cryotherapy


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