Clinical features and outcome of first presentation anogenital warts in men and women

Abstract Objective Correlation of clinical features of patients on initial presentation of anogenital warts to outcome of treatment. Setting Outpatient genitourinary medicine clinic. Method Retrospective cohort analysis. Subjects Eighty‐three male and 60 female patients attending the clinic with first episode anogenital warts within a 3‐month period. Main outcome measures Relapse of warts following treatment. Total time for which treatment was given. Results Following one course of treatment, warts relapsed in 15% of the men, hut in only 37% of the women. After two courses, further relapse occurred in 31% of males and 18% of females (P < 0.001). Treatment for more than 6 months was required for 39% of men, but only 22% of women. Poorer outcome of treatment was related to larger size of warts at presentation. No significant relation was found between outcome and number, site or type of treatment used for warts, or for sexual behaviour or orientation of patients. A previously diagnosed sexually transmitted disease (STD) was reported by 34% of men and 28% of women: 28% of men and 23% of women had an STD diagnosed at the time of presentation with warts. No significant relation was found between outcome and STDs past or concurrent, including HIV. Female patients tended to have smaller warts than men but their better outcome remained significant after controlling for the size of warts. Conclusions Treatment outcome for genital warts is poor and significantly predicted by size of warts at presentation. Female patients have a better outcome from treatment of genital warts than male patients.