A questionnaire on the treatment of anogenital
warts was sent to 150 consultants in genitourinary medicine, 78 (52%) were returned completed. A wide range of treatments were used;
podophyllin was the commonest first line treatment of multiple penile (60.3%), perianal (57.7%) and vulval (61.5%)
warts.
Cryotherapy was a popular choice for intrameatal
warts (65.3%), small numbers of vulval
warts (33.3%) and as second line
therapy for penile (35.9%) and perianal (33.3%)
warts. Vaginal
warts were treated with
podophyllin (39.7%) or
cryotherapy (29.5%). Various combinations of
podophyllin,
trichloroacetic acid and
cryotherapy were used (2.6%-24.3%) although there is no evidence this offers benefit over single
therapy.
Podophyllin is frequently used despite side effects, a poor clearance rate and in vaginal
warts, difficult access. Initial
therapy with more time-consuming procedures such as
cryotherapy or
electrocautery may be of benefit to selected patients.