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.
Böhle
A
A
Department of Urology, Medical University of Lübeck, Germany.
Doehn
C
C
Kausch
I
I
Jocham
D
D
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