CO₂ Laser Surgery for Extensive, Cauliflower-Like Anogenital Condylomata acuminata: Retrospective Long-Term Study on 19 HIV-Positive and 45 HIV-Negative Men

Abstract

Background: Extensive ‘cauliflower-like’ condyloma acuminatum (CA) in males is commonly treated with CO₂ laser surgery or with electrosurgery. Studies on the long-term outcome in this specific situation are scarce. Objectives: To determine the cure and recurrence rate in relation to the HIV status and endoanal location of lesions. To determine the complication rate and patient satisfaction. Methods: Questionnaire-based retrospective long-term study on 64 consecutive men (answer rate 60% or 64/107 addressed persons). The mean follow-up was 25 months (range 7–75). Results: The overall cure rate after 1 intervention was 67%. The cure rate in HIV-positive versus HIV-negative patients was 58 versus 71% (odds ratio = 1.79; p = 0.38). Endoanal versus perianal location was associated with a cure rate of 56 versus 84% (odds ratio = 4.06; p = 0.03). After a second treatment session, the cure rate increased to 79% or higher in all subgroups. Painful defecation for an average of 4–5 weeks was the main postoperative complaint. Severe complications were not seen or reported. Conclusions: The CO₂ laser is a valuable and safe treatment to debulk extensive ‘cauliflower- like’ anogenital CA in males. The healing rate in HIV-positive patients is not significantly lower than in HIV-negative patients. Endoanal location of lesions is a risk factor for recurrence.

Detection of Human Papillomavirus Type 58 in Polydactylous Bowen’s Disease on the Fingers and Toes of a Woman – Concurrent Occurrence of Invasive Vulval and Cervical Carcinomas

“…There have been reports about successful treatment of HPV-associated diseases, such as common warts, verrucous carcinoma, Bowen’s disease and so on, with topical imiquimod alone, CO 2 laser surgery or a combination of topical imiquimod and CO 2 laser ablation [18, 19, 20, 21]. …”

Surgical Outcomes in Human Immunodeficiency Virus–Infected Patients in the Era of Highly Active Antiretroviral Therapy

“…This finding is those of similar to previous studies with far fewer HIV-infected patients. [13][14][15][16] However, there was a trend toward more complications in the HIVnoninfected patients undergoing cardiothoracic surgery; potential selection bias of the HIV-infected patients undergoing these operations cannot be excluded.…”

Ultrasonic Technology: A New Treatment Option for Anal Condylomata Acuminata

“…19 Other sequelae include recurrent anal fissures, perianal dermatitis, and prolonged painful defecations. 20 No such complications have occurred after Harmonic® Scalpel application. Animal studies demonstrated that acute inflammation response resolved completely two weeks after Harmonic® Scalpel injury, whereas leukocyte infiltration and tissue necrosis were observed at least for four weeks after laser and bipolar electrosurgical application.…”