Search

Background: Cidofovir is an antiviral agent which inhibits the DNA polymerase of different viruses. Its use has been described for papillomavirus infections., Methods: Descriptive retrospective study, including patients with difficult to treat anogenital warts who were treated with cidofovir cream., Results: Nine immunocompetent patients were treated, where 6 of them had a complete response and 3 of them a partial response., Conclusion: Cidofovir cream could be a useful therapeutic alternative, although further studies are required to establish the best dosage and its cost-effectiveness., (Copyright © 2012 Elsevier España, S.L. All rights reserved.)

Buschke-Löwenstein tumor is a slowly growing neoplasm with high potential of local invasion. We described a 29 year-old female with acquired immunodeficiency syndrome who was surgically treated for a Buschke- Löwenstein tumor with a wide local excision, bilateral gluteal flaps and loop ileostomy. At 12 months follow-up, there was no evidence of recurrence. Despite it does not metastasize, Buschke-Löwenstein tumor has a high recurrence rate and a 50% risk of malignant transformation into squamous cell carcinoma. Surgery is considered the treatment of choice for this disease. Podophyllin, immunotherapy, interferon and radiotherapy are other treatments with a limited therapeutic response.

Objective: The aim of this study was to describe the clinical characteristics of the patients infected with the human immunodeficiency virus (HIV), who were submitted to anorectal surgery with emphasis on healing time and complications., Methods: The patients were evaluated prospectively from July 1998 to July 1999; there was a total of 23 patients HIV (+) (Group 1). They were compared to a control group of randomly chosen HIV (-) patients (Group II) to establish the characteristics of each group, the morbidity, and the time of healing. The statistical analysis was performed with the student T test., Results: In Group I, the diagnosis were fistula in the anus, anal fissure, anal abscess, condylomata acuminata, anal ulcer, and cutaneous flaps. Seven patients had a fistulotomy, a drainage of abscess in one, resection of different skin lesions in 12, electrofulguration of condylomata in two, fisturectomy in three and solely biopsy in three. The average healing time was 26.087 days for Group I and 23.21 days for Group II. A comparison between healing time and complications in these two groups was carried out to determine a whether significant difference exists in these parameters. There was no significant difference between these groups, but there were unequal rates of healing (26.087, DE +/- 10.778 days vs 23.21 DE +/- 6.259 days; p = not significant) and complications for the similar procedures., Conclusions: The healing in time HIV (+) patients submitted to anorectal surgery may not vary important when compared with HIV (-) patients.

Since no antiviral treatment exists for human papilloma viruses (HPV), the clinician's role is to treat all detectable lesions in order to help the patient's immune system fight the virus and to prevent transmission by contact with lesions. HPV-associated lesions have been treated by a wide range of modalities, which may be divided into chemical, surgical and immunity-stimulating methods. We treated patients with large vulva lesions with Electrosurgery in combination with laser CO2 vaporization. HPV-associated lesions have been treated by a wide range of modalities, which may be divided into chemical, surgical and immunity-stimulating methods.

This paper presents a patient with multiple condyloma and a Buschke-Lowenstein tumor in the groin with clinical aspect of a squamous carcinoma. Malignity was histologically ruled out in this case. Lesions were treated by surgery and during the postoperative period, the patient was treated with interferon alpha i.m. at a rate of 9 x 10(6) UI/day three times a week for 3 weeks. One year after the treatment, the patient had not shown any relapse.

Human Papillomavirus (HPV) is the most common infection among women. Natural History of HPV infection has changed as well as diagnosis and treatment. Clinical picture is variable even with spontaneous remission. Molecular Biology for diagnosis and typification of HPV has changed its treatment. The disease can be treated according to clinical experience. Sometimes can not eradicated since just it is impossible make to disappear it from genital tract.

Eight cases are reported about women with the diagnosis of HPV related lesions; a "dot-blot" hybridization technique with radioactive probes was done with each of them, also a conization with a diathermic loop (LLETZ) and a post operative follow-up with methods such as Pap smear, colposcopy and hybridization. We think the way we manage HPV related lesions has the advantage of an accurate diagnosis, with the exact envolved HPV type, and it discards the possibility of an infiltrating carcinoma, after studying the conization sample. Hybridization techniques are complementary to Pap smear in order to know the infective viral type and to exclude a possible occult infection in the post-operative period. LLETZ conization ended up as a quick and easy technique with no postoperative problems and with a proved efficiency, since neither recurrences were found (with citology) nor viral DNA was detected, the technique is not too complicated and takes about 30 minutes.

Cluster condyloma is currently one of the sexually transmitted diseases of higher incidence. The most common sites for condyloma in males are the balanopreputial sulcus, frenulum and the glans' mucosa. Associated to penis condyloma there can be urethral lesions in 5% of patients which in 80% of cases develop less than 3 cm from the meatus. This paper presents a series of 14 cases of cluster intraurethral condyloma managed by transurethral electrofulguration. The technique consists in the introduction of a coagulation probe through the urethrotome and the application of electrofulguration to the condyloma base. Results have been satisfactory although relapse has occurred in 2 cases (14%), and in one of them the procedure had to be repeated up to 3 times. There has been no complications such as stenosis in the loop resections. The authors conclude that due to the difficulties in the medical management of these lesions, the use of invasive techniques, of which transurethral electrofulguration of the condyloma base with endoscopic urethrotome is the choice because of its simplicity and effectiveness, is justified.

Perianal condyloma acuminatum is a lesion rarely seen in children or babies. We report three new cases of this disease in children less than 3 years of age. There was no evidence of the mechanism of transmission in these cases. All patients underwent radical surgical excision. In one case, surgical treatment was needed on two different occasions due to the extension of the warts. None of the patients showed any recurrence of condyloma over a follow-up period of six years.

Genital papillomavirus is an infection sexually transmitted, besides it is frequently associated with cancer of the uterine cervix. It is controversial if it is useful to treat the sexual partner. The present study analyzes in a comparative way patients with CIN with treated partner and untreated partner. From 1986 to 1991 251 women treated for CIN, were prospectively studied; they had completed a one year follow up and during this time they presented, or not, treatment failure. Fifty six were examined and their sexual partners were treated for genital papillomavirus, and the control were 195 women, similar to the study group as to age, race, socio-economical level, CIN histological degree, distribution of lesions and therapeutical methods, in whom the male was not examined nor treated. Statistical methods were Umann-Whitney, homogeneity test, and the fractions difference test to compare the groups. It were obtained the persistence and recidive of the treated couple and untreated couple (41% vs 32.8% with P greater than 0.05) not significant, which shows that papillomavirus treatment of the male partner has no effect on CIN treatment failure in the woman. These statistical results should be considered with caution as it is known that the male is a virus reservoir that together with other cofactors may explain the greater risk for the woman to develop CIN.

The causal lesions by VPH in the cervix, are associated to cancer. Currently 56 different subtypes have been isolated, from which, the 16, 18, 31, 33, 35 and 39 are more frequently related with the cervical intraepithelial neoplasia; from here derives the importance of opportune treatment. The objective of this paper is to evaluate VPH of the cervix opportune treatment with cryosurgery. Seventy five patients were analyzed, from April 1988 to May 1990 with diagnosis of cervical VPH, by cytology, colposcopy and histopathology; in whom cryosurgery with double freezing technique, was practiced; and were evaluated ever six months, during two years with cytology and colposcopy. Whenever there was persistence or recurrence, cryosurgery was used again; doing this even three times, previously discarding intraepithelial cancer. Seventy seven per cent of the patients received only one session; 16% two, and 7% three. At the six months review, it was found that 92% of the cases were negative, and 8% with persistence; at 12 months, 89% negative and 11% with recurrences; at 18 months, 93% negative, 3% with persistence and 4% with recurrence; at 24 months, 96% negative and 4% with recurrence. It is concluded that cryosurgery is efficacious in the treatment of these lesions, easy to use, well tolerated, with minimal side effects, it does not require anesthesia and is of a low cost.

An analysis is made of 3,184 cases of cryosurgery of the uterine cervix treated along 18 years for diverse types of lesions: 2,050 cases of ectropion of the cervix (64.38%), 811 chronic cervicitis (25.47%), 48 eversions of the cervical canal (1.51%), 24 of cervical condyloma acuminata (0.75%) and 251 of CIN (7.88%). A nitrous oxide cryosurgical system was used. This study evaluate the features of the cryolesion, correlating the freeze time, the size of the frosted area around the probe, the size of the resulting ice-ball and the depth of the epithelial tissue necrosis microscopically measured. For this study cryosurgery was applied to the cervix of 56 women, 1 to 7 days before hysterectomy was performed for benign disease. Statistical analysis was made using regression-correlation calculations to determine the correlation coefficient (r), concluding that the freezing effect and the depth of tissue necrosis are not correlated with the freeze time, but it was demonstrated that there is a reliable correlation between the width of the frosted area around the probe and the depth of tissue necrosis. The extension of cryolesion was influenced by the type of probe, the anatomical position in the cervix, shape of the external is and freeze time, which may be related with the pressure of the gas and the possible clogging of the tubes by pollution. In this paper it is studied too the histopathologic features of the cryolesion. The results obtained in the diverse groups of treated lesions were: 1. In 92% of cases of mucous ectropion of the cervix, one treatment was enough to heal the lesion.(ABSTRACT TRUNCATED AT 250 WORDS)

A case of condyloma acuminata occupying almost the entire penile urethra is reported herein. The literature is reviewed highlighting its etiopathogenesis, histologic features, and treatment according to the stage of the disease. The different treatment modalities that have been utilized and those currently used are described, with a special emphasis on the increasing importance of laser therapy. Some considerations are presented relative to diagnosis, and a therapeutic protocol according to the stage of the disease is described. Due to the high incidence of recurrence, close follow-up of these patients is advocated.