Carbon dioxide (CO(2)) laser ablation treatment of a peri-urethral genital wart: A case report

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. CO(2) laser ablation is the best treatment option for warts that present as refractory, thick, extensive lesions. CO(2) 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, CO(2) 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 CO(2) laser ablation offers complete removal for most patients with limited side-effects. Accurate follow-up is necessary to monitor proper recovery. CONCLUSION: CO(2) laser ablation is considered an effective form of therapy in cases where immediate removal is desired and surgical excision is not recommended. CO(2) laser ablation provides high clearance rates and minimal instances of recurrence, as well as superior aesthetic outcome.