CO2 Laser Therapy versus Cryotherapy in Treatment of Genital Warts: A Randomized Controlled Trial

Abstract

Background: External genital warts are among the common causes of sexually transmitted diseases. Human papillomavirus is known as the main etiology of genital warts and the role of specific types of this virus in pathogenesis of cervical cancer has been recognized for decades. However, there are still many controversies regarding the best treatment of this infectious disease. Methods: In this randomized controlled trial, 160 patients with genital warts were enrolled into the study. Eighty patients were treated with CO2 laser and 80 patients were treated with cryotherapy. They were evaluated for clearance rate, complications and recurrence rate during a 3-month follow-up period. Findings: Seventy six lesions (95%) in CO2 laser therapy group and 37 lesions (46.2%) in cryotherapy group were completely cleared. The clearance rate was significantly different between groups (P < 0.001). 12% and 12.2% of the lesions in cryotherapy group required second and third applications to completely clear, respectively. However, in CO2 laser group, lesions just required one session of therapy to clear. The CO2 laser therapy was associated with less recurrence rate compared to the cryotherapy (0.05% vs. 0.18%). Conclusion: The overall efficacy of CO2 laser in the treatment of external genital warts was approximately two-folds greater than that of cryotherapy. In addition, CO2 laser therapy was associated with lower recurrence rate than cryotherapy.

Keywords

• Genital warts
• Human papillomavirus
• CO2 laser
• Cryotherapy