Treatment of external genital warts at Planned Parenthood Federation of America centers

To compare patterns and cost of treating external genital warts (EGW) at 5 major Planned Parenthood Federation of America (PPFA) affiliates.

Charts of 422 women and 78 men treated for EGW were reviewed. Treatment must have been successful and occurred at a single clinic. Data included anatomic site, number and dates of office visits, treatment modality and cost.

Women required average of 3.01 visits and average cost of $291.36 to reach clearance and males 2.35 visits and $301.81. Monotherapy TCA required 3.2 visits and $263.65 while cryotherapy alone required 3.3 visits and $481.97. Initial imiquimod monotherapy required 2.3 visits and $217.62. Combination therapy of imiquimod and trichloroacetic acid averaged 1.5 visits and $236.53. The largest reduction in visits and cost occurred in patients with multiple or recurrent EGW and those requiring >3 visits. From these data an EGW treatment algorithm was developed allowing more effective management and better utilization of health care resources.

In the PPFA clinic setting, imiquimod alone or in combination should be initial treatment for patients with multiple or recurrent EGW or for those who do not experience complete clearance by the third clinic visit when nonimiquimod therapy is first employed.