Liquid Nitrogen Versus Trichloro-Acetic Acid For The Treatment Of Genital Warts

Mohamed Amer, Karim Abd-El-Maeboud, Fekrya Salama, Mohamed Hamed Abd El-Aziz, Mohamed Reda, Alaa Rashed

Abstract


Objective: Comparing the efficacy and side effects of Trichloroacetic acid (TCA) and liquid nitrogen (LN) in the treatment of genital warts.

Design: Randomized controlled trial.

Participants and methods: Sixty women with genital warts presenting for treatment in Ain Shams University Maternity Hospital were included in this study. They were randomly classified to be treated with liquid nitrogen Group A (n=30) or Trichloroacetic acid Group B (n=30). They were followed up weekly for residual lesions, wound discharge, dyspareunia, inflammation, raw area, hypo pigmentation, scaring and recurrence. The two-tailed student t-test was used for continuous variables, and the chi square, Fisher’s exact test, Relative risk (95% confidence interval) for categorical variables.

Results: Individuals with residual lesions in LN and TCA groups after one, two or three treatment sessions were not different (being 60% vs. 46.7%; 40% vs. 26.7%; and 20% vs. 13.3%; respectively). Wound discharge and raw area show no significant differences between both groups. There was a statistically significant difference in favor of group A regarding postoperative pain with median (IQR) of (2 (2-3) vs. 4(2-5)), and dyspareunia, inflammation, hypopigmentation and scaring with RR (95%CI) of 7 (1.38 to 35.48) , 3.5 (1.53 to 8.03) , 3.5 ( 1.53 to 8.03)  and 16    ( 3.22 to 79.56 ) respectively.

Conclusion: LN and TCA are of comparable efficacy in treating genital warts with significantly less side effects in LN therapy. Further larger scale confirmatory studies are needed.

Keywords: Genital warts, liquid nitrogen, Trichloroacetic acid.


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