Laporan Kasus: Kutil Kelamin pada Uretra dan Meatus Uretra yang Diterapi dengan Krim 5-Fluorourasil 5%

Abstract

Angka kejadian kutil kelamin (KK) di seluruh dunia terus meningkat. Sampai saat ini belum terdapat terapi yang lebih unggul dibanding dengan terapi lainnya. Krim 5-fluorourasil (5-FU) 5% merupakan salah satu terapi untuk KK pada meatus uretra dan uretra. Krim 5-FU 5% adalah antimetabolit pirimidin fluorinated yang memiliki fungsi sebagai agen antineoplastik dengan menghambat sintesis DNA. Seorang pasien laki-laki berusia 27 tahun dengan KK tipe kondiloma akuminta (KA) di meatus uretra dan uretra. Pada meatus uretra dan uretra tampak lesi papula ukuran 0,3x0,5x0,2 cm, sewarna kulit dan mukosa dengan permukaan yang tidak rata, pemeriksaan acetowhite positif, dan pemeriksaan polymerase chain reaction (PCR) positif untuk HPV tipe 6. Pasien diterapi dengan krim 5-FU 5% yang diaplikasikan 3 hari berturut-turut setiap minggu per siklus. Setelah mengaplikasikan krim 5-FU 5% selama 3 siklus, didapatkan lesi pada meatus uretra dan uretra menghilang pada pengamatan hari ke-29 serta tidak timbul lesi baru hingga hari ke-180. Hasil, krim 5-FU 5% untuk KK pada meatus uretra dan uretra memiliki efektivitas yang bervariasi, berkisar 25-95%, dan rekurensi sebesar 50%. Penggunaan krim 5-FU 5% efektif untuk lesi KK berukuran kecil pada meatus uretra dan uretra, dapat diaplikasikan sendiri oleh pasien, mudah digunakan, dan murah. Simpulan, krim 5-FU 5% merupakan terapi yang efektif untuk KK di meatus uretra dan uretra.

Effectiveness of 5-Fluorouracil 5% Cream in Perianal Condylomata Accuminata Treatment: A Case Report

“…1 It is estimated that around 500,000 to 1,000,000 new CA cases are diagnosed annually. 2 The prevalence rate of CA in Indonesia estimated around 5-19%. This was supported by a study conducted at the Bali Sanglah Hospital in 2015-2017, and it reported a higher prevalence in males than females.…”

“…6 The ideal therapy for CA should be simple, inexpensive, effective, and does not cause side effects. 2 Specific therapy is not yet available so that eradication is not maximal, causing a significant clinical problem and frequent recurrences. 2,7 The standard therapies for anal warts require medical professionals to apply, such as trichloroacetic acid, CO2 laser, cryotherapy, and cautery.…”

“…2 Specific therapy is not yet available so that eradication is not maximal, causing a significant clinical problem and frequent recurrences. 2,7 The standard therapies for anal warts require medical professionals to apply, such as trichloroacetic acid, CO2 laser, cryotherapy, and cautery. These therapies have a higher risk, may cause uncomfortable feeling, and require specific care.…”

“…These therapies have a higher risk, may cause uncomfortable feeling, and require specific care. 2,10 Some self-applied therapies are podofilotoxin creams 0.15%, imiquimod 5% cream, or 5-FU 5% cream. 5-Fluorouracil 5% is a treatment option for perianal wart lesions that easily applied, inexpensive, effective, does not cause side effects, and can be used by the patient himself.…”

“…5-Fluorouracil 5% is a treatment option for perianal wart lesions that easily applied, inexpensive, effective, does not cause side effects, and can be used by the patient himself. 2,8 Unfortunately, 5-FU 5% cream is not yet available in Indonesia as a ready-to-use preparation. But Nugrahaini et al reported that genital warts on the urethra and meatus urethra treated with 5-FU cream 5% for 2-3 times a week have resulted in complete resolution after 29 days and no recurrence until the 6 th month.…”