Topical 5-fluorouracil in the treatment of cervical human papillomavirus infection.

Chemosurgical treatment of vaginal/cervical human papillomavirus (HPV) infection with 5-fluorouracil (5-FU) is limited by vulvar pain and dysuria resultant from leakage and vulvar/urethral tissue reaction to the 5-FU. Women with cervical HPV DNA identified by in situ hybridization on colposcopically directed biopsy were treated with topically applied 5% 5-FU cream. A fitted cervical cap was used to restrict exposure to 5-FU. Repeat biopsies and in situ hybridization at least 6 weeks after application failed to detect HPV DNA in 6 of 7 patients. In 1 case, 5-FU treatment was associated with a decreased intensity of detectable HPV DNA. No episodes of vulvar pain or dysuria occurred. 5-FU can be used in the treatment of cervical HPV with minimal side effects when applied utilizing a cervical cap.