5-Fluorouracil in the treatment of penile and urethral condylomata acuminata.

Abstract

SUMMARY 5-Fluorouracil (5-FU) cream was compared with podophyllin 25 % 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 notcured, warts regressed afterfour weeks infour more patientsin each group. Patients were followedup 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 discovered; this prompted us to introduce an instrument to examine the urethral meatus and the fossa navicularis.

Long‐term Results of Carbon Dioxide Laser Treatment of Meatal Condylomata Acuminata

“…Many methods are available for the treatment of condylomata and new methods are often introduced before proper appraisal of the preceding ones. In the only controlled study of urethral condylomata, the cure rates were 33 and 53% for 5-fluorouracil and podophyllin respectively (Wallin, 1977). Problems arise in carrying out a satisfactory investigation because recurrences may be grossly invisible ; using an operating microscope, however, a recurrence rate of 66% for external lesions was found after 4 months (Carpiniello et al, 1987), which resembles our figures.…”

Intraurethral fluorouracil and lidocaine for intraurethral condyloma acuminata

“…Although various attempts have been made to control the application of the drug (including the use of viscous gels and even suppositories), developing a preparation and means of administration that avoid the spillageinduced scrotal lesions has proven to be difficult. 11,13,14,16 We found that the use of a 2% lidocaine syringe, prepared with fluorouracil as described above, provides a safe and convenient means of administering the drug intraurethrally. Further studies need to be performed to confirm these observations.…”

“…The necrosis and disappearance of the warts leave temporarily denuded areas of mucosa; therefore, irritation during treatment does frequently occur and appears to be a function of the initial wart burden. 13 Treatment with fluorouracil has not been associated with the formation of strictures or other significant adverse effects. 18 In theory, the methods described could carry a risk of cardiac toxicities as a result of systemic lidocaine absorption, but even if 100% of the lidocaine hydrochloride were absorbed, it would only be approximately 10 mg.…”

“…No recommendations are offered in the Morbidity and Mortality Weekly Report guidelines. 11 There have been a number of reports of successful treatment with intraurethral application of various fluorouracil preparations (Table 1), [12][13][14][15][16][17] and one study found the use of fluorouracil intravaginally to be efficacious for the treatment of women with internal vaginal warts. 18 A new and convenient means of administering fluorouracil in men for the treatment of intraurethral condyloma acuminata that provides efficacy without the previous problems of spillage and containment is discussed.…”

Natural Interferon Alfa for Treatment of Condylomata Acuminata

“…Table 2 summa¬ rizes these prior therapies. (53) 8 (9) 4 (5) 7 (8) 21 (24) 43 (60) 14 (19) 10 (14) 1 (1) 9 (12) 11 (15) 12 (17) 6 (8) 9 (12) Figure 2 shows views of genital warts and their complete disappearance after therapy with interferon alfa. In men, hypopigmentation of the treated area was observed frequently after warts disappeared completely (Fig 2, bottom left).…”