The CO2 laser for recurrent and therapy-resistant condylomata acuminata.

The medical records of 48 patients who underwent laser vaporization of therapy-resistant or recurrent condylomata acuminata were studied with regard to history of immunosuppression, location of original lesion, type and duration of therapy, and whether magnification devices were used prior to or during therapy. The genitalia of the patients' sexual partners were examined in all cases in which the condylomata recurred after initial control of the lesions with conventional methods. In 46 of the 48 cases, possible reasons for the failure of conventional therapy could be found: unresponsive to chemical therapy (11 patients); reinfection by the sexual partner (4); immunosuppression (8); several factors (6); and incomplete eradication of the lesion (20). Thirty-eight of the 48 patients (79%) were treated successfully with one-time laser ablation of the lesions. Six patients with recurrent condylomata after laser therapy underwent a second laser treatment, and four of the six patients (total, 87%) have remained free of disease. The laser appears to be an effective method of treatment for recurrent or persistent condylomata acuminata provided that (1) the patient is not immunosuppressed, (2) the potentially infected sexual partner is examined and treated, if necessary, and (3) the external genitalia, including the anus, vagina and cervix, are carefully examined colposcopically to rule out the persistence of small lesions.