Comparative Efficacy of Ultrasonic Scalpel Surgery With Photodynamic Therapy Versus Trichloroacetic Acid Application in Treating HPV-Related Condyloma Acuminata: A Randomized Clinical Trial.
Summary
In this RCT, ultrasonic scalpel excision followed by single-session PDT outperformed 80% TAA for condyloma acuminata: fewer sessions, better cosmetic results, and 0% recurrence at 18 months versus 33.3% with TAA. Patient-reported PDT pain limited adherence, highlighting a need for protocol optimization.
Key Findings
- US+PDT required fewer treatment sessions than 80% TAA monotherapy.
- Cosmetic outcomes were superior in the US+PDT group.
- Recurrence at 18 months was 0% with US+PDT versus 33.3% with TAA.
- Pain during PDT limited adherence and completion rates.
Clinical Implications
Consider US+PDT as a first-line or second-line option for condyloma acuminata when cosmetic outcomes and recurrence reduction are priorities. Implement analgesia/sedation strategies and optimize PDT protocols to improve tolerability and adherence.
Why It Matters
Provides randomized evidence for a combined surgical–PDT approach that may replace or complement TCA in condyloma management with superior cosmetic and recurrence outcomes.
Limitations
- Sample size and detailed CONSORT elements are not specified in the abstract.
- Potential lack of blinding and pain-related discontinuations may introduce bias.
Future Directions
Conduct larger multicenter, blinded RCTs, refine PDT parameters and analgesic regimens to improve tolerability, and assess cost-effectiveness and quality-of-life outcomes.
Study Information
- Study Type
- RCT
- Research Domain
- Treatment
- Evidence Level
- I - Randomized controlled trial comparing two active treatments with long-term follow-up.
- Study Design
- OTHER