The Efficacy of Podophyllin Cautery Added to Surgical Excision for Eradication of Vulvar Condylomata Accuminata; Randomized Controlled Trial

Abstract

Context: Condyloma acuminatum is a common morbidity caused by human papillomavirus infection. Objective: To compare the recurrence rate after surgical excision with or without podophyllin cautery. Design, Setting, Participants: Sixty women were enrolled in a study that was conducted in Cairo from Jan-2017 to Mar-2018. Interventions: All women received the same preparations. After randomization; in the study group (N = 30), podophyllin cautery was added to surgical removal in the follow-up period. In the control group (N = 30), only surgical removal was used. Main Outcome Measure: The main outcome measure was the estimation of the recurrence of the lesion during the follow-up period. The secondary outcome measures were the incidence of adverse events. Results: Both groups were comparable (p-value > 0.05) with regard to the age and BMI. Recurrence was significantly lower (P = 0.001) in the study group than the control group. In the study group, five cases (17.2%) have recurrence whereas, in the control group, 18 (60.0%) had suffered recurrence. The ARR was 42.8% (CI 95%: 18%-60.9%) with RR of 0.29 (CI 95%: 0.12%-0.67%) and NNT2 (CI 95%: 6%-2%). During the follow-up period, 19 cases (65.5%) of the study group experienced pain versus only eight cases (26.7%) in the control group (p = 0.003). However, the development of scars was less in the study group 7 (24.1%) than in the control group 19 (63.3%), (p = 0.002). Conclusion: Podophyllin cautery, when added to surgical removal, is effective in decreasing the incidence recurrence in cases with condylomata acuminata.

Case Report: The Effect of 25% Podophyllin Tincture in Condylomata Accuminata

“…There is no proof that one type of treatment is notably better than the other or even acceptable for all types of warts. According to the data, only surgical treatments have a primary clearance rate that is almost 100%, and recurrence occurs in all treatments at a rate of 20% to 30% or more [17]. Excision of the lesion is the main modality in eradicating CA lesions.…”