Carbon dioxide laser treatment for vulval papillomatosis (vulvodynia)

Genital papillomatosis accompanied by distressing vulval symptoms is often termed vulvodynia. Common presenting symptoms are vulvar burning, pruritus and dyspareunia. Sixteen patients with vulval papillomatosis (vulvodynia) have been treated by carbon dioxide laser therapy over a 4-year period. Initial responses at 6 weeks appeared encouraging but with follow-up it became apparent that the relapse rate was high, with a mean symptom-free interval of 4.6 months. Of the 16 patients treated, only three remain symptom free. In view of our findings, we recommend that laser therapy should not be offered as a primary procedure, if at all, for patients with vulval papillomatosis.