High- and low-power CO2 lasers. Comparison of results for three clinical indications

In this prospective study, three groups of patients were enrolled: group 1, patients with high grade squamous intraepithelial lesions (CIN 2 and 3) and carcinoma in situ (n = 56); group 2, patients with benign vulvar and perineal human papillomavirus lesions (n = 83); and group 3, patients with disseminated foci of penile shaft condylomatous lesions (n = 65). Each of the groups was randomly equally divided into two subgroups. One subgroup was treated with a laser beam with an output of 60 W and a spot size of 1-1.5 mm, creating high power density (HPD) ranging between 3,4000 and 7,640 W/cm2, while the other was treated with low power density (LPD) with an output of 20 W and the same spot sizes, creating an LPD ranging between 1,136 and 2,547 W/cm2. In group 1, the time to complete treatment was shorter using the HPD technique (P < .0003), and more satisfactory histologic edges were available (P < .007). HPD was also associated with a significantly shorter healing time and improved cosmetic results in groups 2 and 3 (P = .001). No difference was found in the time to complete therapy or the occurrence of infection when the different modalities were compared. The results of this study suggest that for specific disease entities, HPD is associated with better treatment outcomes than is LPD.