OBJECTIVES

To evaluate the efficacy of topical application of viable bacille Calmette-Guérin (BCG) as a primary line of treatment in patients with condylomata acuminata.

METHODS

We recruited 50 patients from the Department of Andrology and Sexually Transmitted Diseases, Cairo University Hospital complaining of genital warts. Patients were divided into two groups. Group 1 consisted of 25 patients who received BCG as a weekly topical treatment for 6 consecutive weeks. If still resistant, another intensive three-times-a-week course for 3 consecutive weeks was given. Group 2 consisted of 25 patients who received 0.9% saline solution as a placebo solution with the same procedure and follow-up as for group 1. All patients were followed up for 6 consecutive months. During the treatment course, the local response, wart state and size, and any side effects were reported.

RESULTS

A complete response with the disappearance of all condylomata acuminata was achieved in 20 (80%) of the 25 patients after a maximum of six BCG applications. Three patients (12%) needed another, more extensive, course, resulting in complete clearance 3 weeks later. Only 2 patients (8%) did not achieve a full response even after application of the intensified BCG course. No response was detected in the placebo group, with no improvement during follow-up. No recurrence developed in any responder. Minimal side effects, such as transient erythema and fever, were recorded during the study.

CONCLUSIONS

Topical BCG in the treatment of genital warts attained a high success rate in our study compared with the placebo solution, with insignificant side effects and no recurrence.