CO2 Laser Therapy versus Cryotherapy in Treatment of Genital Warts: A Randomized Controlled Trial

Document Type : Original Article(s)

Authors

1 Associate Professor, Skin and Stem Cell Research Center, Department of Dermatology, Hazrat Rassoul Akram Hospital, Tehran University of Medical Sciences, Tehran ,Iran

2 Student of Medicine, Skin Diseases and Leishmaniasis Research Center And Student Research Committee, Isfahan University of Medical Sciences, Isfahan And School of Medicine,Tehran University of Medical sciences, Tehran, Iran

Abstract

Background: External genital warts are among the common causes of sexually transmitted diseases. Human papillomavirus is known as the main etiology of genital warts and the role of specific types of this virus in pathogenesis of cervical cancer has been recognized for decades. However, there are still many controversies regarding the best treatment of this infectious disease.Methods: In this randomized controlled trial, 160 patients with genital warts were enrolled into the study. Eighty patients were treated with CO2 laser and 80 patients were treated with cryotherapy. They were evaluated for clearance rate, complications and recurrence rate during a 3-month follow-up period.Findings: Seventy six lesions (95%) in CO2 laser therapy group and 37 lesions (46.2%) in cryotherapy group were completely cleared. The clearance rate was significantly different between groups (P < 0.001). 12% and 12.2% of the lesions in cryotherapy group required second and third applications to completely clear, respectively. However, in CO2 laser group, lesions just required one session of therapy to clear. The CO2 laser therapy was associated with less recurrence rate compared to the cryotherapy (0.05% vs. 0.18%). Conclusion: The overall efficacy of CO2 laser in the treatment of external genital warts was approximately two-folds greater than that of cryotherapy. In addition, CO2 laser therapy was associated with lower recurrence rate than cryotherapy.

Keywords

References

  1. Dunne EF, Friedman A, Datta SD, Markowitz LE, Workowski KA. Updates on human papillomavirus and genital warts and counseling messages from the 2010 Sexually Transmitted Diseases Treatment Guidelines. Clin Infect Dis 2011; 53(Suppl 3): S143-52.
  2. Dillner J, Brown DR. Can genital-tract human papillomavirus infection and cervical cancer be prevented with a vaccine? Expert Rev Mol Med 2004; 6(9): 1-21.
  3. af Geijersstam V, Eklund C, Wang Z, Sapp M, Schiller JT, Dillner J, et al. A survey of seroprevalence of human papillomavirus types 16, 18 and 33 among children. Int J Cancer 1999; 80(4): 489-93.
  4. Dunne EF, Unger ER, Sternberg M, McQuillan G, Swan DC, Patel SS, et al. Prevalence of HPV infection among females in the United States. JAMA 2007; 297(8): 813-9.
  5. Bosch FX, Lorincz A, Munoz N, Meijer CJ, Shah KV. The causal relation between human papillomavirus and cervical cancer. J Clin Pathol 2002; 55(4): 244-65.
  6. Walboomers JM, Jacobs MV, Manos MM, Bosch FX, Kummer JA, Shah KV, et al. Human papillomavirus is a necessary cause of invasive cervical cancer worldwide. J Pathol 1999; 189(1): 12-9.
  7. Schlecht NF, Kulaga S, Robitaille J, Ferreira S, Santos M, Miyamura RA, et al. Persistent human papillomavirus infection as a predictor of cervical intraepithelial neoplasia. JAMA 2001; 286(24): 3106-14.
  8. Parkin DM, Bray F. Chapter 2: The burden of HPV-related cancers. Vaccine 2006; 24(Suppl 3): S3-11-S3/25.
  9. Woodhall S, Ramsey T, Cai C, Crouch S, Jit M, Birks Y, et al. Estimation of the impact of genital warts on health-related quality of life. Sex Transm Infect 2008; 84(3): 161-6.
  10. Mortensen GL, Larsen HK. The quality of life of patients with genital warts: a qualitative study. BMC Public Health 2010; 10: 113.
  11. Desai S, Wetten S, Woodhall SC, Peters L, Hughes G, Soldan K. Genital warts and cost of care in England. Sex Transm Infect 2011; 87(6): 464-8.
  12. McClean H, Shann S. A cross-sectional survey of treatment choices for anogenital warts. Int J STD AIDS 2005; 16(3): 212-6.
  13. Ting PT, Dytoc MT. Therapy of external anogenital warts and molluscum contagiosum: a literature review. Dermatol Ther 2004; 17(1): 68-101.
  14. Kumar B, Narang T. Local and systemic adverse effects to topical imiquimod due to systemic immune stimulation. Sex Transm Infect 2011; 87(5): 432.
  15. Sonnex C, Lacey CJ. The treatment of human papillomavirus lesions of the lower genital tract. Best Pract Res Clin Obstet Gynaecol 2001; 15(5): 801-16.
  16. Maw R. Critical appraisal of commonly used treatment for genital warts. Int J STD AIDS 2004; 15(6): 357-64.
  17. Scheinfeld N, Lehman DS. An evidence-based review of medical and surgical treatments of genital warts. Dermatol Online J 2006; 12(3): 5.
  18. Workowski KA, Berman S. Sexually transmitted diseases treatment guidelines, 2010. MMWR Recomm Rep 2010; 59(RR-12): 1-110.
  19. Collet-Villette AM, Gaudy-Marqueste C, Grob JJ, Richard MA. Carbon dioxide laser therapy for anogenital warts in children. Ann Dermatol Venereol 2007; 134(11): 829-32.
  20. Wiley DJ, Douglas J, Beutner K, Cox T, Fife K, Moscicki AB, et al. External genital warts: diagnosis, treatment, and prevention. Clin Infect Dis 2002; 35(Suppl 2): S210-24.
Journal of Isfahan Medical School
Volume 29, Issue 173 - Serial Number 173
November and December 2012
Pages 3016-3022

Files

History

  • Receive Date: 12 March 2012
  • Revise Date: 01 November 2024
  • Accept Date: 06 April 2022

Share

How to cite

Statistics