Laser treatment of urethral condyloma: a five-year experience.

Objective: Twenty cases of men treated with the neodymium:yttrium-aluminum-garnet (Nd:YAG) laser for meatal and/or urethral condyloma over five years were reviewed.
Method: All patients underwent Nd:YAG laser treatment of visible lesions as outpatients under general anesthesia using the visual urethrotome sheath and 0 degree lens. Follow-up urethroscopy was performed at three-month intervals. Cure of the gross disease was defined as negative findings on two sequential follow-up urethroscopies.
Results: All patients with gross condylomatous disease were verified to have type 6/11 human papillomavirus. Ninety-five percent had meatal condylomata of which 42 percent had concomitant distal urethral lesions. Thirty percent were cured of gross disease after one treatment, while 40 percent needed two, three, four, or five separate treatments before gross cure was obtained. Thirty percent had insufficient follow-up. Only 2 of the patients experiencing recurrence did so after negative finding on one follow-up urethroscopy.
Conclusions: We believe attempts at cure of gross urethral condylomatous disease should be made because of its unsightliness and symptoms such as split stream and bleeding. Cure of gross disease with the Nd:YAG laser, as evidenced by our results, is possible. However, it may require several treatments. Follow-up urethroscopy is recommended in all patients because of the high incidence of recurrence and concomitant distal urethral involvement in those patients with meatal disease.