Treatment of urethral condyloma acuminatum with 5-fluorouracil cream

doi:10.1016/0090-4295(77)90218-7

Urology

Volume 9, Issue 4, April 1977, Pages 413-415

https://doi.org/10.1016/0090-4295(77)90218-7 Get rights and content

Abstract

Total eradication of intraurethral condyloma acuminatum was accomplished in 10 of 11 patients by intraurethral administration of 5 per cent 5-fluorouracil cream.

References (10)

D.B. Halverstadt et al.
Thiotepa in the management of intraurethral condylomata acuminata
J. Urol.
(1969)
N.K. Bissada et al.
Extensive condylomas acuminata of the entire male urethra and bladder
J. Urol.
(1974)
J.H. Gigax et al.
The successful treatment of intraurethral condyloma acuminata with colchicine
J. Urol.
(1971)
J.W. Rosenberg et al.
Management of intraurethral condyloma acuminatum
J. Urol.
(1973)
S.P. Dretler et al.
The eradication of intraurethral condyloma acuminata with 5 percent 5-fluorouracil cream
J. Urol.
(1975)

There are more references available in the full text version of this article.

Cited by (24)

Update on the Medical and Surgical Management of Urethral Condyloma
2022, Sexual Medicine Reviews
Citation Excerpt :
Regular surveillance is required to ensure that growth does not preclude less invasive treatment options, and patients should be counseled to notify their provider if they notice rapid growth of the lesion as this should prompt intervention (Figures 2–4). Topical 5-FU is not a first-line treatment for external genital warts due to decreased efficacy relative to other options; however it has been demonstrated to have therapeutic effect for external genital CA in a systematic review65 and multiple reports have shown that its intraurethral use is safe and well-tolerated.36,39,61,66-70 5-FU is an antimetabolite drug that is an analogue of uracil and exerts its mechanism of action via rapid cell entry using facilitated transport mechanisms.
Condyloma acuminata (CA) of the urethra presents a management challenge due to high recurrence rates, difficulty in accessing urethral lesions, risk of stricture formation, and potential for sexual dysfunction. While standard treatment modalities are acceptable for some external genital condyloma, they are not always feasible or appropriate for urethral lesions.
We sought to review the literature on epidemiology, presentation, diagnosis and treatment of urothelial CA with a focus on surgical treatment options.
We performed a comprehensive literature search of PubMed to identify all studies pertaining to urethral CA through November 2020.
Urethral CA is a relatively rare, but challenging disease to manage with a considerable amount of treatment side effects and downstream morbidity associated. In our comprehensive review we have found a wide selection of treatment modalities ranging from minimally invasive strategies to surgical reconstructive techniques. Proper follow-up to monitor for disease recurrence at the 3–4 month mark is appropriate and will determine subsequent treatment strategies as needed. Future studies and treatment directions include novel drug delivery models to optimize minimally invasive topical drug efficacy.
Treatment of urethral CA should be approached in a step-wise fashion. Medical therapy would be an appropriate option for asymptomatic or minimally symptomatic patients with small lesions who desire to avoid any interventions. If patient is symptomatic, has extensive disease burden or has failed medical therapy intervention should be considered with options including PDT, laser ablation or surgical excision with or without urethral reconstruction. Appropriate selection depends on patient characteristics and preferences along with prior treatment history.
Kim CJ, Campbell SP, Allkanjari A, et al. Update on the Medical and Surgical Management of Urethral Condyloma. Sex Med Rev 2022;238–252.
Pan-urethral condylomata acuminata – A primary treatment recommendation based on our experience
2020, Urology Case Reports
Citation Excerpt :
At check cystoscopy there remained a single papilloma at the navicular fossa which was removed again by cold cup biopsy forceps. Both Wallin et al. and Wein et al. encountered similar difficulties with clearance of CA within the navicular fossa using 5FU.1,4 Following the findings of recurrence of CA in the navicular fossa after 2 courses of 5FU, we adopted the patient occluding the most distal portion of the glans in an effort to improve instillation time of 5FU and reduce risk of glans irritation.
We present a case of a 28 year old man presenting with obstructive urinary tract symptoms and cystoscopic findings of pan-urethral, occlusive condylomata acuminata (urethral genital warts). We describe the in rooms administration process of 5-fluorouracil over an 8 week period with follow up cystoscopy results. Urine flow rates improved early in the treatment course from a maximum flow of 7ml/s to 19ml/s and a post void residual improvement from 311ml to 160ml. Significant volume reduction of the warts was achieved allowing for limited treatment with cold excision to minimise urethral stricture risk in a young man.
Natural history, management, and surveillance of recurrent squamous cell penile carcinoma: A risk-based approach
2003, Urologic Clinics of North America
Therapy of anogenital HPV-induced lesions
1997, Clinics in Dermatology
Diagnosis and therapy of intraurethral condylomata acuminata
1997, Journal of the European Academy of Dermatology and Venereology
Background Condylomata acuminata is one of the commonest sexually transmitted diseases. The urethra is involved in up to 30% of cases.
Case report A case of intraurethral condylomata acuminata is presented as an illustration of diagnosis and therapy.
Comment Meatoscopy allows direct visualisation of meatal condylomata. Ascending urethrogram or contrast voiding cysturethrography can show filling defects suspicious of condylomata acuminata: urethroscopy is diagnostic. In the author's opinion, laser therapy is the treatment of choice.
Indications for Urethroscopy in Male Patients With Penile Condylomata
1995, The Journal of Urology
Benson et al recommended that to detect condylomata, urethroscopy should be performed on the male partners of women with cervical dysplasia. Considering this, in April 1990 we began to perform urethroscopy on all of our patients who presented with genital condylomata. Between April 1990 and January 1993, 84 patients were referred for initial evaluation of condylomata. The penis, scrotum, perineum and perianal areas were inspected, and the penis was reinspected after staining with 5 percent acetic acid. Intraurethral condylomata were detected in 13 patients (15 percent), 11 of whom had visible lesions on physical examination with spreading of the meatus. Urethroscopy confirmed these lesions to be limited to the fossa navicularis. Two patients had lesions of the fossa not visible at the meatus. No patient in this series had lesions of the more proximal urethra. All patients eventually determined to have intraurethral lesions had external condylomata on the distal penis (glans, corona or frenulum). Using the presence of distal penile lesions as the criterion for urethroscopy, 30 patients (36 percent) would have undergone urethroscopy, including all 13 eventually diagnosed to have intraurethral condylomata, for a yield of 43 percent. A total of 54 patients (64 percent) who failed to meet this criterion would have been spared the procedure. Consideration of dysuria or urinalysis did not improve the yield. When evaluating male patients with genital condylomata, we recommend spreading the urethral meatus during the examination. Urethroscopy is indicated only for those with distal penile or meatal lesions.

View all citing articles on Scopus

View full text

Scientific articleTreatment of urethral condyloma acuminatum with 5-fluorouracil cream

Abstract

J. Urol.

J. Urol.

J. Urol.

J. Urol.

J. Urol.

Scientific article
Treatment of urethral condyloma acuminatum with 5-fluorouracil cream