Clinical Efficacy of Combination Therapy with Podophyllotoxin and Liquid Nitrogen Cryotherapy in the Treatment of Genital Warts in Men.

High prevalence, peculiar etiopathogenesis, and ineffective therapies have contributed to the fact that genital warts are one of the most challenging issues in modern medicine. This prospective study was aimed at determining the clinical efficacy of combination therapy with 0.5% podophyllotoxin solution and liquid nitrogen cryotherapy in the local treatment of genital warts in men. One hundred and ten consecutive male patients with genital warts were randomly assigned to two groups. The control group consisted of two subgroups: 30 patients treated with podophyllotoxin and 30 patients treated with cryotherapy. The experimental group included 50 patients treated with combination therapy. The therapy continued until complete regression, but not longer than six weeks. Analysis of the average increase in the number of cleared warts compared to week zero found a significant clinical improvement in the group treated with a combination therapy in relation to the group treated with podophyllotoxin at the end of each of the six weeks and in comparison with the group treated with cryotherapy at the end of each of the first three weeks. After discontinuation of therapy, a significantly lower recurrence rate and appearance of new condylomas was observed at the end of the third month in the group treated with a combination therapy compared with each group treated with monotherapy, and at the end of the sixth month compared with patients treated with cryotherapy. The combination of podophyllotoxin and cryotherapy showed a significantly higher efficacy in the treatment of genital warts in comparison with monotherapy with podophyllotoxin after 6 weeks of treatment (P<0.001), with considerably lower recurrence and appearance of new warts compared with cryotherapy during the 6 months after therapy (P<0.005).