The Outcome of Combined Electro-fulguration and Surgical Excision Techniques in the Management of Anogenital Condylomas

Abstract

Aim:Condyloma accuminata (anogenital warts) refers to an epidermal manifestation attributed to human papilloma virus (HPV). It is the most common sexually transmitted disease. In this study, we present our experience with anogenital warts and surgical treatment outcomes.Method:From 2013 to 2018, 53 patients with anogenital warts underwent electro-fulguration (cauterization) and surgical excision under local or general anesthesia. Demographics, localization of lesions, serological tests, final histopathological results, outcomes and recurrence rates were documented.Results:There were 37 men (69.8%) and 16 women (30.1%). The mean age was 37 years (range= 17-53). Local or general anesthesia was applied according to the localization, distribution and volume of the lesions (n=46, 86.7% vs. n=7, 13.2%, respectively). Surgical excision was performed for histopathological examination, and electro-fulguration was applied for multiple smaller lesions. The perianal region was the most common location for HPV-related warts (n=24, 64.8% for men vs. n=14, 87.5% for women). Human immunodeficiency virus (HIV) positivity was seen in three patients (5.6%). Hepatitis serology was positive in two cases (3.7%). There was no permanent surgical morbidity. During a mean follow-up period of 31 months (range: 5-61 months), recurrence was seen in five cases (9.4%), and two of them were HIV positive (40% of recurrent cases).Conclusion:HPV-related anogenital warts remain one of the most common sexually transmitted diseases. Surgical excision to confirm diagnosis and fulguration of the remaining lesions can be recommended in practice. HIV positivity and high recurrence rates are the most important problems to be encountered.

Keywords

• anogenital condyloma
• warts
• human papilloma virus
• surgical excision
• electro-fulguration
• cauterization