TREATING VAGINAL AND EXTERNAL ANOGENITAL CONDYLOMAS WITH ELECTROSURGERY VS CO2-LASER ABLATION

Our objective was to assess the technical characteristics, side effect s, complications, and effectiveness of electrosurgery vs continuous wa ve CO2 laser in the treatment of genital warts, This open clinical tri al was made up of 208 evaluable patients (135 women and 73 men) with v aginal and external anogenital condylomas, To avoid selection bias, in each patient half of the lesions measuring 2 cm(2) or greater total l inear area were treated with loop electroexcision and ball electrofulg uration, and the other half were treated with CO2 laser excision and v aporization in a continuous wave mode spot welding. All patients were followed for at least 6 months (maximum 18 months, mean 8 months) afte r the last treatment received, The average operative time was 6 min fo r electrosurgery and 8 min for laser, Healing was completed in 95% of patients with a lesional area of 5 cm(2) or less and 100% of patients with 5 cm(2) or larger by the third and sixth postoperative week, resp ectively, Severe discomfort occurred in 12% of patients, and 4% of pat ients developed delayed complications, including vitiligo and scarring , irrespective of treatment modalities used, Complete clearance of war ts in women and men after a single (51% and 38%) and multiple (75% and 64%) treatments were similar in areas treated with electrosurgery and CO2 laser. Electrosurgery appears to be as effective as continuous wa ve CO2 laser for treating vaginal and external anogenital condylomas, particularly those limited to a 5 cm(2) or less area.