CO2 Laser therapy versus cryotherapy in treatment of genital warts; a Randomized Controlled Trial (RCT)

Background and Objective: Genital warts, due to specific types of the human papillomavirus, have long been regarded as one of the most important causes of cervical cancer and one of the most common cause of Sexually Transmited Diseases (STDs). Over the years, it has been the focus of several studies in order to find the best effective approach to eradicate the virus, however there are still controversies regarding this matter. We compared efficacy of the two physical ablative therapies; Liquid Nitrogen and CO2 laser. Material and Methods: One hundred and sixty patients, with external genital warts, were divided into two groups. Each group consisted of 80 patients treated with CO2-laser or cryotherapy. Clearance and recurrence rates were evaluated for 3 months. Results: Complete clearance was achieved in 76 lesions (95%) treated by CO2-laser and 37 lesions (46.2%) treated by cryotherapy which was significantly different (p < 0.001). In the CO2-laser group, lesions required only one treatment to clear while in the cryotherapy group, lesions required two (12%) even up to three (12.2%) treatments for some patients to clear completely. Laser therapy was associated with less recurrence rate compared to cryotherapy (0.05% Vs 0.18%). Conclusion: Generally, the efficacy of CO2 laser treatment of external genital warts was approximately two fold greater than cryotherapy and it was associated with lower recurrence rate.