Treatment of perineal condylomata acuminata by CO2 laser ablation and curettage: 12 years of experience

Abstract

Abstract Background Perineal condylomata acuminata (PCA) are caused by the human papillomatavirus. The incidence of PCA is increasing and becoming a serious public health problem. The primary goal of treatment is to eliminate symptomatic warts. At present, no single treatment is ideal for all patients or all warts. Conservative treatment has been associated with either local or systemic adverse reactions and recurrence rates of 15–65%. Surgical therapy has the advantage of eliminating warts in most cases at a single session. It is safe during pregnancy and has no adverse effects related to locally applied drugs. Objective To present a modified method of laser ablation for PCA. Our experience highlights the simplicity and usefulness of the technique that is based on complete removal of the lesion by curettage after CO2 laser ablation. Method We retrospectively reviewed our experience in 61 patients who underwent CO2 laser ablation and curettage of PCA during the last 12 years. Results All patients were cured in one or two sessions. We did not observe any bleeding from the treated surface and none of the patients complained of severe pain. There were no septic complications. One patient suffered from fibrotic anal scarring. The recurrence rate was 8.2%. All recurrences were successfully treated by a second laser ablation session. Conclusion This retrospective long-term study advocates the use of CO2 laser ablation and curettage as a favorable technique for cure of the condylomata lesions. It involves a minimal complication rate, low recurrence rate, satisfactory clinical and cosmetic results and no additional cost. CO2 laser ablation and curettage is an effective method for the treatment of PCA, with a low recurrence rate, minimal complications and satisfactory cosmetic results.