Carbon dioxide (CO2) laser ablation treatment of a peri-urethral genital wart: A case report

• Main Authors: Paula Gutierrez, John Garza, Kushal Gandhi, Alesia Voice, Elea Stout, Gary Ventolini
• Format: Article
• Language: English
• Published: Elsevier 2020-07-01
• Series: Case Reports in Women's Health
• Subjects: Human papillomavirus; Genital wart; Sexually transmitted disease; CO2 laser ablation; Case report
• Online Access: http://www.sciencedirect.com/science/article/pii/S2214911220300564

Background: Visible genital warts are caused by the nearly 100 recognized strains of human papillomavirus (HPV). HPV infections caused by high-risk strains are associated with significant morbidity and mortality rates. Genital warts are diagnosed by visual inspection and treated by three major methods: topical agents, systemic agents, and surgical therapies. CO2 laser ablation is the best treatment option for warts that present as refractory, thick, extensive lesions. CO2 ablation offers benefits such as a painless procedure, increased clearance rate, lesser side-effects and decreased pain. Case Presentation: An 18-year old patient was referred to the obstetric/gynecology clinic and presented with severe urinary complications. She complained of dysuria, frequency, vaginal irritation, and spraying while voiding. Physical exam was within normal limits; however, genital examination revealed a 3 cm fungating mass corresponding to a large genital wart at the urethral meatus and peri-urethral area. Due to her progressing symptomatology, CO2 laser ablation therapy was advised. Discussion: HPV directly impacts the public health system, affecting 1% of the US population with an estimated 10–20% prevalence rate. Treatment options such as CO2 laser ablation offers complete removal for most patients with limited side-effects. Accurate follow-up is necessary to monitor proper recovery. Conclusion: CO2 laser ablation is considered an effective form of therapy in cases where immediate removal is desired and surgical excision is not recommended. CO2 laser ablation provides high clearance rates and minimal instances of recurrence, as well as superior aesthetic outcome.