podophyllin and Urethral-Neoplasms

This article describes an approach to the evaluation and treatment of condyloma acuminatum (anogenital warts) that is based on the results of new clinical research on the biology of the human papillomavirus. A more extensive diagnostic protocol, including routine cervicovaginal examination and Papanicolaou smear, is proposed for female patients because of the close association of genital human papillomavirus infections with cervical carcinoma. Two highly effective therapies, cryosurgery and carbon dioxide laser photocoagulation, are described and compared with older regimens. Recent developments in immunotherapy for resistant condyloma acuminatum are also discussed.

Topics: Clinical Trials as Topic; Condylomata Acuminata; Cryosurgery; Electrocoagulation; Female; Fluorouracil; Genital Neoplasms, Female; Genital Neoplasms, Male; Humans; Immunotherapy; Interferons; Laser Therapy; Male; Ointments; Papanicolaou Test; Podophyllin; Urethral Neoplasms; Uterine Cervical Neoplasms; Vaginal Neoplasms; Vaginal Smears

Topics: Condylomata Acuminata; Cryosurgery; Humans; Male; Nitrous Oxide; Podophyllin; Urethral Neoplasms

5-Fluorouracil (5-FU) cream was compared with podophyllin 25 percent in alcohol for treating genital and urethral condylomata acuminata. The cure rate after four weeks was found to be 6 of 18 patients treated with 5-FU and 10 of 19 treated with podophyllin. By changing the treatment for those not cured, warts regressed after four weeks in four more patients in each group. Patients were followed up for four to nine months; 10 of 27 treated with 5-FU and 14 of 31 treated with podophyllin remained in remission. It is not possible to support earlier reports on the successful treatment of meatal warts using 5-FU cream. More than half of the patients given 5-FU reported side effects after 10 to 14 days' treatment, which in some cases led them to stop using the cream. Twenty-one men considered to be treatment failures or relapses were examined by urethroscopy. No intraurethral condylomata were found but three cases of warts in the fossa navicularis were doscovered; this prompted us to introduce an instrument to examine the urethral meatus and the fossa navicularis.

Topics: Condylomata Acuminata; Fluorouracil; Humans; Male; Penile Neoplasms; Podophyllin; Urethral Neoplasms