Sexually transmitted papillomaviral infections: III. Management of male partner.

The treatment of 199 males afflicted with sexually transmitted papillomaviral infections has shown that to be successful, periodic and prolonged follow-up is necessary to detect recurrent disease. Results of superficial epidermectomy using a battery-powered eye cautery in 49 cases with a few clusters confined to the shaft showed a 40 per cent recurrence rate. The carbon dioxide (CO2) laser was successful in eradicating 75 to 82 per cent of the cases presenting with extensive subclinical and exophytic disease. Meatal as well as perianal infection responded adequately to a single vaporization, using power densities ranging from 200-500 W/cm2 in 98 per cent and 78 per cent of the cases, respectively. Scrotal disease was best managed by the topical application of 5-fluorourocil with a cure rate of 82 per cent and in 36 per cent (17 cases) spontaneous disappearance with a faint acetowhite stain suggesting an abortive type of infection. It is apparent that to be effective the successful treatment of papillomaviral infections in the male must rely on periodic and prolonged follow-up to detect recurrent disease, and must include different treatment modalities to be used in accordance with clinical presentation and anatomic location of the disease.