Pulsed dye laser versus Nd:YAG laser in the treatment of male genital wart: A comparative randomized clinical study

Background: Genital warts caused by human papillomavirus (HPV) that can cause discomfort and significant patient distress. To date therapies for the male genital warts are known for high recurrence rates and bothersome side effects. Objective: To compare the clinical outcomes in the treatment of genital warts on the male external genitalia using PDL versus Nd:YAG. Methods: The study included 32 male patients with multiple genital warts from June 2013 to January 2017. In each patient, lesions were divided into two groups: Group A were treated with PDL (spot size, 5 mm; energy, 15 J/cm2 and pulse duration, 0.5 ms). Group B were treated with Nd:YAG laser (spot size, 5 mm; energy, 80 J/cm2 and pulse duration, 20 ms). Laser sessions were applied every 2 weeks with maximum of 3 sessions. Clearance rate, recurrence rate and complications were evaluated and compared by 2 independent dermatologists. Results: The study included 32 male patients with a mean age of 29.6±7.34 years. The cure rate was 76.25 % with PDL treated sites (group A) with significant difference from Nd:YAG laser treated sites (group B) (88.75 %) (P<0.005). Relapse was recorded in 8 patients (25 %) in group A compared with 13 patients (40.62 %) in group B with no significant difference (p =0.18). There was a significant difference between complication rates between both laser types which was higher in group B. Pain score was significantly higher with Nd:YAG laser than PDL. Conclusion: Both PDL and Nd:YAG laser are effective therapeutic modalities for genital warts but there were higher cure rate and less recurrence rate with Nd:YAG laser. Additionally, Nd:YAG laser was more painful and showed higher susceptibility to complications compared to PDL.