Successful Pregnancy after a One-Stop Comprehensive Endoscopic Management of Overt and Hidden Genital HPV Infection

Darwish A

Department of Obstetrics and Gynecology, Assiut University, Egypt

^*Correspondance to: Atef M.M. Darwish 

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Abstract:

Background: High recurrence rate follows local monotherapy or combined therapy of overt External Genital HPV Warts (EGW). Case Report: The present case describes a secondary infertile woman who presented with External Genital Warts (EGW) resistant to sequential surgical excision then eleven sessions of topical Trichloroacetic Acid (TCA) application. At the time of presentation, she underwent a one-stop endoscopic intervention to search for the primary lesions. Vulvoscopy confirmed the diagnosis of EGW; vaginoscopy diagnosed hidden vaginal warts. and cervicoscopy revealed abnormal cervical lesions including punctations, mosaicism, and abnormal blood vessels. Endocervical canal and endometrial cavities were free as seen by hysteroscopy. Concomitant excision of the vaginal, vulvar, perineal, and perianal warts was performed with punch biopsy forceps, while a Large Loop Excision of the Transformation Zone (LLETZ) was performed for the cervical lesions. Six months later, she got pregnant and delivered a healthy female baby by caesarean section. Three-month postpartum follow-up revealed no recurrence of any genital HPV. Conclusion: It is concluded that hidden genital tract infections including HPV should be screened for women presenting with unexplained infertility. In cases of recalcitrant (refractory) condyloma (EGW), screening and one-stop prompt treatment of the whole genital tract lesions using a multifunctional endoscope, is an efficient and quick fertility-enhancing line of management.

Keywords:

Pregnancy; Infertility; Colposcopy; Hysteroscopy; Vulva; Vagina; Cervix; HPV; Condyloma

Cite the Article:

Darwish A. Successful Pregnancy after a One-Stop Comprehensive Endoscopic Management of Overt and Hidden Genital HPV Infection. World J Surg Surgical Res. 2024; 7: 1557..