[Genital condylomas in women. Treatment using a CO2 laser: analysis of 141 cases]

141 patients who had lesions caused by human papilloma virus (HPV) in the vulva and vagina (63 cases) or in the cervix (78 cases) were routinely treated solely by using CO2 laser. The lesions were vaporized when they were localised to the perineum and in certain selected cases in the cervix after they had been examined colposcopically and had biopsies taken. We resorted to conisation when lesions were not completely visible or when they were associated with CIN III (severe dysplasia and carcinoma in situ). Vulvo-vaginal condylomata present with certain characteristics: the infected population is young (a mean age of 27), most (81%) have diffuse forms of the condition, of the partners examined 68% were contaminated. Association with flat cervical lesions with or without dysplasia is not rare (18% of cases). Finally, treatment using only CO2 laser seems to us to be disappointing: only 55% were cured after one treatment and 84% after repeated treatments. When the condylomatous lesions on the cervix were flat we found an associated intra-epithelial neoplasia (CIN) in 66% of cases. In these cases the mean age of the patients was 28 years when these were pure viral lesions and 33 years of age when there was an associated dysplasia. Here the results after laser treatment can be considered as satisfactory because they were respectively 97 and 94% of cures whether the lesions had or did not have dysplasia. On the other hand, in our series the junction between pavement and cylindrical cells was always visible after treatment with the laser, and that made it easy to follow up these patients.