Cryotherapy in the management of histologically diagnosed subclinical human papilloma virus (HPV) infection of the cervix

Abstract

The aim of the study was to establish the efficacy of cryotherapy in the management of histologically diagnosed subclinical human papilloma virus (HPV) infection of the cervix. Women with genital warts who had subclinical HPV infection of the cervix and no other sexually transmitted diseases were followed up at six weeks, 12 weeks, six months, 12 months and 18 months after treatment with cryotherapy. They came to the out-patient department of genito-urinary medicine (GUM) at St Luke's Hospital, an open clinic without any appointment system. Two hundred and fifty-five patients with genital warts took part in the study. They underwent clinical genital examination, along with cytology, colposcopy and colposcopically directed cervical punch biopsies. Sixty-three of them had subclinical HPV infection of the cervix only, and were considered suitable for cryosurgery. Twelve weeks after treatment only one patient developed clinical warts on the cervix, which increased to three patients (4.8%) after 12 months. No further patients developed any clinical cervical warts. In the untreated group development of clinical warts was noticed in five patients (20%) after 18 months. The difference was significant. The failure rate for the histologically diagnosed subclinical HPV infection was 38% in the treated group, whereas it persisted in 76% of the untreated group. Cryotherapy was found to be successful in the treatment of subclinical HPV infection and prevented the development of clinical disease. There were no serious side-effects and the treatment can be administered easily in an out-patient setting after histological confirmation.