Carbon dioxide laser ablation of anogenital condyloma acuminata in pediatric patients

The treatment of anogenital condyloma acuminata in pediatric patients is difficult, with a wide range of treatment strategies that yield variable success. Treatment regimens must consider the patient age, and etiology, location, and severity of lesions. We report our experience using the carbon dioxide (CO2) laser to ablate these lesions. A retrospective review of a single surgeon's series of 17 consecutive patients was performed. A staging system was developed and used to document the extent of disease as related to prognosis, recurrence rates, and treatment options. There were 17 patients (5 males and 12 females). Eleven patients (65%) were treated after failing previous treatment. Perianal disease was noted in 14 of 17 patients (82%). No patients presented with stage I disease, 7 patients (41%) presented with stage II, 5 patients (29%) presented with stage III, and 5 patients (29%) presented with stage IV disease. Recurrence occurred in 4 of 17 patients (23%). Persistent disease occurred in 1 patient (6%). CO2 laser vaporization of anogenital condyloma acuminata in pediatric patients is safe, relatively atraumatic to the child, and associated with favorable recurrence rates. A staging scheme has been proposed in predicting recurrences, complications, and guiding therapy.