Ultrasonic technology: a new treatment option for anal condylomata acuminata.
OBJECTIVE
Treatment options for anal and perianal warts caused by human papillomavirus include topical application of cytotoxic substances or immunomodulators and ablative procedures. The objective of this prospective study was the evaluation of the ultrasound-driven Harmonic Scalpel (Ethicon Endo-Surgery, Norderstedt, Germany) for resection of anal and perianal condylomata acuminata.


METHODS
Eight men and three women (age range, 26-72 years) with anal and perianal condylomata acuminata were treated by a Harmonic Scalpel blade operating at a vibration frequency of 55.5 kHz and within a temperature range of 65 degrees C to 120 degrees C. Nine patients were treatment naïve, and two patients had recurrent disease. Follow-up ranged from 4 to 26 months.


RESULTS
Seven patients had perianal condylomata, two patients had exclusively intra-anal, and two patients had perianal and intra-anal warts. All condylomata were excised in a single-step procedure with complete clearing without injury of subepidermal layers. We observed no intraoperative or postoperative complications. No recurrences occurred during follow-up.


CONCLUSIONS
The Harmonic Scalpel has been an effective and safe method for the treatment of anal perianal human papillomavirus condylomata without recurrent warts. Subepidermal skin levels remained uninjured; thus, no complications or unsatisfactory cosmesis occurred.
Colombo-Benkmann
Mario
M
Department of General and Visceral Surgery, University of Münster, Münster, Germany. m.colombo.benkmann@uni-muenster.de
Tübergen
Dirk
D
Buchweitz
Olaf
O
Senninger
Norbert
N
D000328:Adult; D000368:Aged; D001004:Anus Diseases / Q000473:pathology / Q000628:therapy*; D002425:Cautery / Q000295:instrumentation*; D003218:Condylomata Acuminata / Q000473:pathology / Q000628:therapy*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D016896:Treatment Outcome; D014464:Ultrasonic Therapy / Q000295:instrumentation*