Cryosurgery of genital warts in cases in which podophyllin treatment failed or was contraindicated.

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Abstract
A total of 56 cases with warts, in which podophyllin treatment was either contraindicated or a failure, were treated with nitrous oxide using a Keymed 500 cryosurgical appliance. Of these, 43 patients who completed treatment were followed-up for 3 mo. Thirty-seven of these had received applications of podophyllin twice weekly for an average period of 3 mo. before cryosurgery. The remaining cases in whom podophyllin was considered to be contraindicated included 5 with vulval warts (2 were pregnant, 2 were bronchial asthmatics taking oral prednisolone and 1 was taking oral clomiphene citrate) and a diabetic patient with penile warts. There were 32 cures and 11 relapses. The latter were re-treated at the end of the follow-up period with 2 freezing cycles of 45 s at an interval of 30 min. Seven were cured and the remaining 4 men who failed to respond belonged to the podophyllin-resistant group and included 3 with meatal warts and 1 homosexual with anogenital warts. Cryosurgery gave a cumulative success rate of 91%. A single freezing cycle was free from complications but a double freezing cycle was often followed by severe local reaction.