Treatment of recurrent penile condylomata acuminata with external application and intraurethral instillation of bacillus Calmette-Guerin.
OBJECTIVE
Condylomata acuminata are caused by human papillomavirus infection. Despite numerous treatment modalities these patients often demonstrate recurrent disease. We report initial experience with bacillus Calmette-Guerin (BCG) therapy in patients not responding to standard treatment.


METHODS
Between October 1994 and March 1997, 6 men with rapidly recurrent external and intraurethral condylomata acuminata underwent BCG therapy after initial laser treatment. External application and intraurethral instillation of BCG were performed 6 times in weekly intervals. Followup studies included examination and endoscopic inspection of the urethra and bladder.


RESULTS
Of the patients 3 completed 1 course of BCG and had no relapse of condylomata acuminata, 2 underwent a second course of BCG and 1 had relapse, and 1 had relapse after discontinuing therapy due to penile edema. The annual recurrence rate decreased from 3.2 before to 0.75 after BCG therapy (p < 0.05, test of equality of 2 percentages).


CONCLUSIONS
Immunotherapy with BCG is accepted treatment for superficial transitional cell carcinoma. The BCG induced immune response appears to reduce the recurrence rate in patients with condylomata acuminata.
Department of Urology, Medical University of Lübeck, Germany.
A
A
Böhle
C
C
Doehn
I
I
Kausch
D
D
Jocham
D000276:Adjuvants, Immunologic / Q000008:administration & dosage / Q000627:therapeutic use*; D000279:Administration, Cutaneous; D000287:Administration, Topical; D000328:Adult; D001500:BCG Vaccine / Q000008:administration & dosage / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D003218:Condylomata Acuminata / Q000601:surgery / Q000628:therapy* / Q000821:virology; D003558:Cystoscopy; D005500:Follow-Up Studies; D006801:Humans; D007167:Immunotherapy; D053685:Laser Therapy; D008297:Male; D027383:Papillomaviridae; D030361:Papillomavirus Infections / Q000601:surgery / Q000628:therapy; D010409:Penile Diseases / Q000601:surgery / Q000628:therapy* / Q000821:virology; D012008:Recurrence; D014412:Tumor Virus Infections / Q000601:surgery / Q000628:therapy; D014521:Urethra / Q000473:pathology; D001743:Urinary Bladder / Q000473:pathology
D000276:Adjuvants, Immunologic; D001500:BCG Vaccine