7. dr Haykal - Energy Based Device on Sexually Transmission Diseases (STD).pdf

Energy Based
Device on Sexually
Transmission
Diseases (STD)
dr. Ahmad Haykal, Sp.KK, M.Kes
Makassar
Dermatovenerology & Cosmetic Update 2022
Management Pearls and Pitfalls

AIDS
Genital Herpes Simplex
Genital Warts
Tcichomonus Vaginitis and
Urethritis
Scabies
Pediculosis Pubis
Vaginal Thrush
Syphilis
Gonorrhea
Non-Gonorrheal
Urethritis
Chancroid
Non-Specific
Vaginitis
Granuloma
Inguinale
Vulvovaginitis
Balanitis
Viral Bacterial Parasitic Fungal

Symptoms, management and long-term effects
HPV Trichomoniasis Chlamydia Gonorrhea Syphilis Herpes
Symptom
Skin lesions Discharge Discharge Discharge Skin lesions Skin lesions
Long term effects
Genital warts Inflammation PID PID Paralysis Recurring
Management
Can be treated Can be cured Can be cured Can be cured Can be cured Can be treated

• STIs have a profound impact on sexual and reproductive health worldwide.
• More than 1 million STIs are acquired every day.
• In 2020, WHO estimated 374 million new infections with 1 of 4 STIs:1
• Chlamydia (129 million)
• Gonorrhoea (82 million)
• Syphilis (7.1 million)
• Trichomoniasis (156 million)
1. Who, 2021
0
20
40
60
80
100
120
140
160
180
Chlamydia Gonorrhea Syphilis Trichomoniasis
Sexually transmitted diseases (STD) infographics

0
20
40
60
80
100
120
140
160
180
Chlamydia Gonorrhoea Syphilis Trichomoniasis
In 2020, WHO estimated 374 million new infections with 1 of 4 STIs:1
129 milion
Chlamydia
82 milion
Gonorrhea
7.1 milion
Syphilis
156 milion
Trichomoniasis
1. Who, 2021

(A) Global STIs incident cases by age for men and
women combined in 1990 and 2019. For each
group, the left column presents case data from
1990 and the right column presents data from
2019.
(B) Difference by gender in global STI incident
cases by age in 2019 GBD, Global Burden of
Disease; STIs, sexually transmitted infections.
Fu L, Sun Y, Han M, Wang B, Xiao F, Zhou Y, Gao Y, Fitzpatrick T, Yuan T, Li P, Zhan Y, Lu Y, Luo G, Duan J, Hong Z, Fairley CK, Zhang T, Zhao J and Zou H (2022) Incidence Trends of Five Common Sexually Transmitted Infections Excluding HIV From 1990 to 2019 at the Global,
Regional, and National Levels: Results From the Global Burden of Disease Study 2019. Front. Med. 9:851635. doi: 10.3389/fmed.2022.851635
Trends of Five Common
Sexually Transmitted
Infections

Fu L, Sun Y, Han M, Wang B, Xiao F, Zhou Y, Gao Y, Fitzpatrick T, Yuan T, Li P, Zhan Y, Lu Y, Luo G, Duan J, Hong Z, Fairley CK, Zhang T, Zhao J and Zou H (2022) Incidence Trends of Five Common Sexually Transmitted Infections Excluding HIV From 1990 to 2019 at the Global,
Regional, and National Levels: Results From the Global Burden of Disease Study 2019. Front. Med. 9:851635. doi: 10.3389/fmed.2022.851635
Trends of Five Common Sexually Transmitted Infections

https://www.cdc.gov/nchhstp/newsroom/2022/2020-STD-surveillance-report.html

Source : cdc.gov/nchhstp/newsroom

Trends of Five Common
Sexually Transmitted
Infections in Indonesia
Gonorrhea
Estimasi Infeksi Menular Seksual di Indonesia, KEMENKES 2021

Chlamydia

Syphilis

Energy Based Device as new approach

• New therapeutic strategies are urgently needed to overcome
drawbacks in the treatment of some infections, particularly sexually
transmitted infections (STI).
• Several treatment options are developed for eradication of STI, laser
therapy has been shown to be effective in a number of conditions
• Light amplification by stimulated emission of radiation (laser) is a
device that amplifies light and produces coherent light beams.
• The root of this technological innovation lies in physics research.
• The benefits of laser therapy are that it is often a painless procedure
and patients are able to heal quickly with lower infection levels and
low rates of recurrence and complications
Mammari, N.; Hamblin, M.R.; Rauger, P.; Boyer, L.; Varbanov, M. Phototherapy-Based Treatment for Sexually Transmitted Infections— Shining Light into Unexplored Territory. Venereology 2022, 1, 170–186. https://doi.org/10.3390/ venereology1020012
Shah VV, Aldahan AS, Mlacker S, Nouri K. The Evolution of Laser Technology in Dermatology. JAMA Dermatol. 2016;152(2):199. doi:10.1001/jamadermatol.2015.4133
de Lima, M.M., de Lima, M.M. & Granja, F. Treatment of genital lesions with diode laser vaporization. BMC Urol 15, 39 (2015). https://doi.org/10.1186/s12894-015-0033-6
S.Ghiasy,M.Fallah-Karkan,M.R.Razzaghi,A.Ranjbar,A.Rahavian,B.Javanmard,Is holmium laser an appropriate modality to treat genital warts? J. Lasers Med. Sci. 10 (1) (2019) 70–74.

Early 20th Century 1963 1967
1960 1966
1976
1973 1980
Albert Einstein first
proposed the idea of
stimulated emission
Leon Goldman, also
known as the “father
of lasers in medicine”,
was the first to use the
laser in dermatology
Dougherty experimented laser in
activating photosensitive substances
which were able to bind and destroy
cancer cells selectively. This was the
origin of photodynamic therapy.
the Italian scientific group had
been contaminated by laser
technology and in 1979, the first
"Italian Society of Laser Medicine
and Surgery” was born.
Theodore Maiman
at Hughes Aircraft
Company created the
first working laser
Mester,having discovered
the positive effects of low-
energy red laser on hair
growth in rats, decided to
use the same system to
stimulate the healing of
pressure ulcers.
Goldman also introduced
the neo dymium: yttrium-
aluminium garnet (Nd:
YAG) laser in the treatment
of vascular lesions
laser therapy deeply
revolutionized by the
selective photo-thermolysis
theory, postulated by Rox
Anderson and John Parrish
The Evolution of Laser Technology in Dermatology
Gianfaldoni S, Tchernev G, Wollina U, Fioranelli M, Roccia MG, Gianfaldoni R, Lotti T. An Overview of Laser in Dermatology: The Past, the Present and ... the Future (?). Open Access Maced J Med Sci. 2017 Jul 25; 5(4):526-530. https://doi.org/10.3889/oamjms.2017.130

1983 1990
1960
Oshiro Atsumi described the use of
non-surgical lasers and their
mechanisms of action.
In the same time, Passerella was
studying the laser effects on
mitochondria.
Finally, the nineties has been
characterised by an increasing of
study and case reports of laser
resurfacing (Gregory and others), laser
hair removal and laser rejuvenation.
The Food and Drug Administration (FDA)
drew the first guidelines for the use of lasers
in various vascular and dermatological
lesions. From that era, FDA updates them
each year.
The Evolution of Laser Technology in Dermatology

YEAR
PHYSICIANS DISCOVERY
1960
Ali Javan, William Bennett Jr. and
Donald Herriott
Helium-neon (HeNe) laser
1960
Peter P. Sorokin and Mirek J.
Stevenson
Uranium laser
1961
Leo F. Johnson and Kurt Nassau
Neodymium-doped solid state
laser
1961
J. McClung and Robert W.
Hellwarth
Quality switching (Q- switching)
technique to shorten the pulse
length to nanoseconds
1962
Sumner Mayburg and Jacques
Pankove
Semiconductor Diode Lasers
1964
William Bridges Argon Laser
1964
Joseph E. Geusic and Richard G.
Smith
Nd: YAG (neodymium-doped
YAG) laser
1964
Kumar Patel carbon dioxide laser
YEAR
PHYSICIANS DISCOVERY
1967 Bernard Soffer and Bill McFarland Dye laser
1970 Basov, V.A. Danilychev and Yu. M.
Popov
Excimer laser
1972 Charles H. Henry Quantum well laser
1976 John M.J. Madey Free-electron laser (FEL).
1994 Jérôme Faist, Federico Capasso,
Deborah L. Sivco, Carlo Sirtori,
Albert L. Hutchinson and Alfred Y.
Cho
Semiconductor laser that can
simultaneously emit light at
multiple widely separated
wavelengths
1996 Wolfgang Ketterle Pulsed atom laser
1997 Shuji Nakamura, Steven P.
DenBaars and James S. Speck
Gallium-nitride (GaN) laser
2009 Chunlei Guo Femtosecond pulsed laser
Milestones in Lasers Development

DISEASE
DIGNITY ETIOLOGY SHAPE LASER MODE
BD
Malignant
Helium-neon (HeNe)
laser
Intraepidermal,
hyperkeratotic
CO2 Blistering, vaporization
BP
Semialignant Uranium laser
Intraepidermal,
hyperkeratotic
GENITAL WARTS
Benign
Neodymium-doped solid
state laser
Intraepidermal,
hyperkeratotic,
exophytic
CO2, Nd-YAG, argon, dye
Cutting, Blistering,
vaporization
ANAL AND PERIANAL
CARCINOMA IN SITU
Malignant?
Quality switching (Q-
switching) technique to
shorten the pulse length
to nanoseconds
Intraepidermal,
hyperkeratotic
BUSCHKE-LOWENSTEIN
TUMOR
Malignant?
Semiconductor Diode
Lasers
Intraepidermal,
hyperkeratotic
CO2
Cutting, Blistering,
vaporization
KS
Malignant
Argon Laser
Dermal Nd-YAG, CO2, etargon Coagulation
GENITAL HERPES
Benign?
Nd: YAG (neodymium-
doped YAG) laser Vesicular, ulcerating
CO2
Blistering
MOLLUSCUM
CONTAGIOSUM
Benign? carbon dioxide laser Tumorous, ulcerating CO2 Vaporization
Synopsis of the STDs treatable with laser therapy
Laser Therapy. Erich E. Kung. Dermatoiogie am Hauptbahnhof, Zurich, Schweiz *Kaposi sarcoma (KS )Bowenoid papulosis (BP), Bowen's disease (BD), Human papillomavirus (HPV)

Type of Lasers
Features of the carbon dioxide laser are:
• Wavelength in the far infrared range
(10,600 nm); in tissue, the energy of this
quality will be fully absorbed by the
watermolecules.
• This implies that the effect of the carbon
dioxide laser is very superficial with a
limited penetration of less than 0.1 mm.
1,2
• The first effect on the skin is coagulation
of the epidermis and uppermost dermis
(whitening): then blistering of the
epidermis (irradiance < 80 W/cm2) will
occur.
1. Lanigan SW: A review of the laser treatment of vascular naevi. 1 Dermatol 1992;2:113-116.
2. Adler M, Garbe C: Erfahrungen mit dem CO,-Laser in der Dermatochirurgie. Akt Dermatol1989; 15:9-16.
CARBON DIOXIDE

Mehdi MH, Mahmood AS. Treatment of genital warts by using CO2 laser. Med J Babylon 2019;16:94‐8.
CO2 laser system with the surgical handpiece
A 25‐year‐old female with 23 warts papule and cauliflower in the
perineum. (a) Before treatment (b) Immediately after treatment (c)
1 ‐week after treatment
Co2 Laser

Gutierrez P, Garza J, Gandhi K, Voice A, Stout E, Ventolini G. Carbon dioxide (CO2) laser ablation treatment of a peri-urethral genital wart: A case report. Case Rep Womens Health. 2020 May 26;27:e00226. doi: 10.1016/j.crwh.2020.e00226. PMID:
32528860; PMCID: PMC7283141.

Chunyu Cao, Lihua Chen, Shu Li, Lili Yuan, Yishan Wang, "Clinical Efficacy of Carbon Dioxide Laser Combined with ALA Photodynamics in the Treatment of Condyloma Acuminatum", Evidence-Based
Complementary and Alternative Medicine, vol. 2021, Article ID 7211055, 5 pages, 2021. https://doi.org/10.1155/2021/7211055

Le Huu Doanh, Tran Hau Khang, CONDYLOMATA ACUMINATA TREATMENT WITH CARBON DIOXIDE LASER IN COMPARISON WITH 0.15% PODOPHYLLOTOXIN CREAM, LASER THERAPY, 2007

Johnson PJ, Mirzai TH, Bentz ML. Carbon dioxide laser ablation of anogenital condyloma acuminata in pediatric patients. Ann Plast Surg. 1997 Dec;39(6):578-82. doi: 10.1097/00000637-199712000-00004. PMID: 9418915.

Desiate A, Cantore S, Tullo D, Profeta G, Grassi FR, Ballini A. 980 nm diode lasers in oral and facial practice: current state of the science and art. Int J Med Sci. 2009;6(6):358–64.
Genovese WJ, dos Santos MT, Faloppa F, de Souza Merli LA. The use of surgical diode laser in oral hemangioma: a case report. Photomed Laser Surg. 2010;28(1):147–51.
Saetti R, Silvestrini M, Cutrone C, Narne S. Treatment of congenital subglottic hemangiomas: our experience compared with reports in the literature. Arch Otolaryngol Head Neck Surg. 2008;134(8):848–51.
• These light beams are poorly absorbed
by the hard tissue and therefore do not
damage nearby hard tissue.
• By focussing the beam on the desired
area for incision, a highly precise focal
spot can be created. By adjusting the
focus of the beam, the intensity of the
laser light can be varied, which allows
cauterization of small blood vessels and
lymphatics to decrease post–operative
swellings and sealing of nerve endings to
reduce post-operative pain.
• Diode lasers are semiconductors that
change electrical energy into light energy
through the use of solid‐state elements,
such as aluminum and gallium.
• The light beam which is released by the
diode laser falls within the visible and
invisible range of near infrared waves
(with wavelengths varying between 800
and 980 nm) and is able to vaporize soft
tissue due to its high water content.
Diode Laser Vaporization

Comparison of depth of the zone of necrosis of an electrosurg and diode laser Tissue reaction upon contact with an initiated diode laser tip demonstrating the effect as one
moves away from the tip
Kurtzman GM, Mahesh L. Implant Uncovery and Soft-tissue Modification Utilizing a Diode Laser. Int J Oral Implantol Clin Res 2015;6(1):20-25.

Rieken M, Bachmann A. Laser treatment of benign prostate enlargement--which laser for which prostate? Nat Rev Urol. 2014 Mar;11(3):142-52. doi: 10.1038/nrurol.2014.23. Epub 2014 Mar
4. PMID: 24595121.

• The Holmium:YAG (Ho:YAG) laser is a highly
comprehensive tool, using the doping
element holmium as an active medium in a
yttrium-aluminium-garnet (YAG) crystal.
• It is a solid-state, pulsed laser designed for
emitting light at 2100 nm, which is invisible to
the human eye and is in the near-infrared
region of the electromagnetic spectrum.
• Considering that the holmium wavelength can
be transmitted down optical fibers, the
Ho:YAG laser has become a multi-purpose
tool in treatment options
• The optical absorption coefficient for water at
this wavelength is approximately 40 cm-1 so
that the holmium wavelength is absorbed
significantly by water.
• Since tissues are composed mainly of water,
the majority of the holmium energy is
absorbed superficially and this results in issue
cutting and coagulative hemostasis.
Yang CJ, Liu SX, Liu JB, Wang ZY, Luo DF, Zhang GL, Zhang XJ, Yang S. Holmium laser treatment of genital warts: an observational study of 1500 cases. Acta Derm Venereol. 2008;88(2):136-8. doi: 10.2340/00015555-0354. PMID: 18311440.
Holmium YAG Laser

https://www.ems-urology.com/holmiumyag-laser-technology

Liao C, Sun X, Zhang G, Zhang H, Zhang L, Wang X. Advanced application of holmium: YAG laser combined ALA-PDT for the treatment of refractory condylomata acuminata in anal canal. Photodiagnosis Photodyn Ther. 2020 Jun;30:101696. doi: 10.1016/j.pdpdt.2020.101696. Epub 2020 Feb 25.
PMID: 32109616.

Liao C, Sun X, Zhang G, Zhang H, Zhang L, Wang X. Advanced application of holmium: YAG laser combined ALA-PDT for the treatment of refractory condylomata acuminata in anal canal. Photodiagnosis Photodyn Ther. 2020 Jun;30:101696. doi: 10.1016/j.pdpdt.2020.101696. Epub 2020 Feb 25. PMID: 32109616.

Ghiasy S, Fallah-Karkan M, Razzaghi MR, Ranjbar A, Rahavian A, Javanmard B. Is Holmium Laser an Appropriate Modality to Treat Genital Warts? J Lasers Med Sci. 2019
Winter;10(1):70-74. doi: 10.15171/jlms.2019.11. Epub 2018 Dec 15. PMID: 31360372; PMCID: PMC6499586.
This study showed treatment with holmium laser is correlated
with highest clearance rate (92.2%) and lowest recurrence rate
(14.3%) than other applied treatments.
In conclusion, holmium laser is safe, and more effective, than
other methods.

1. Lanigan SW: A review of the laser treatment of vascular naevi. 1 Dermatol 1992;2:113-116.
2. Adler M, Garbe C: Erfahrungen mit dem CO,-Laser in der Dermatochirurgie. Akt Dermatol1989; 15:9-16.
The ND-YAG laser machines produce a good
coagulation at a depth of 4-6 mm. and may
therefore be of great value particularly in
the treatment of vascular inflammatory or
tumorous diseases of the skin such as KS or
botryomycoma.
• Due to the emitted wavelengths of
1,064, 532 and 355 nm, the energy is
absorbed partly by the water molecules
but also by melanin pigment and
hemoglobin.
• In accordance with the lower superficial
absorption rate compared to the carbon
dioxide laser, the energy transfer to the
deeper layers is higher This results in a
deeper tissue penetrance than with the
carbon dioxide laser.
Nd-YAG Laser

Bahmer FA, Tang DE, Payeur-Kirsch M. Treatment of large condylomata of the penis with the neodymium-YAG-laser. Acta Derm Venereol. 1984;64(4):361-3. PMID: 6209903.

• Exposure of the condylomata to the Nd-YAG laser beam resulted in an
immediate vaporization of the lesions with smoke formation.
• A biopsy performed immediately after the laser therapy showed
destruction of the entire epidermis extending through the upperdermis
to a total depth of l mm .
• These wounds were treated daily with sulfadiazine cream and healedin
threeweeks without leaving a visible scar.
M. Lowy; D. Geeraerts; R. van Velthoven (1988). Treatment of condylomata acuminata with the Nd-YAG laser. , 3(1-4), 119–121. doi:10.1007/bf02593799

• In this laser type,the primary tissue
chromophores are melanin pigment and
hemoglobin.
• Produces a blue-green light that has two
distinct bands at 488 nm and 518 nm
• Can be transmitted through water or
quarts fibers of 200 to 600 micron
diameter
• Hemoglobin and other deeply colored
pigments absorb their wavelengths and
are responsible for their use in vascular
and pigmented lesion
• Penetration into skin, typically 1 to 2mm, is
affected by the concentration of skin
pigments.
• It produce a moderate scatter 100 times that
of CO2 laser. This results in an excellent
hemostasis.
• Because of scatter, they have minimal cutting
ability. The depth of tissue injury is roughly
correlated with the laser power settings.
ARGON/DYE LASER

• Another antimicrobial PT strategy, water-
filtered infrared A combined with visible light
irradiation, has been shown to be effective
against genital Chlamydia trachomatis
bacterial infection, and an optical nano-
genosensor has been designed for the
diagnosis of trichomoniasis, a parasitic
Trichomonas vaginalis infection
• Phototherapy is a major therapeutic
approach based on the controlled
administration of light in the visible, near
infrared, or UV spectrum, with or without
the application of an external
photosensitizer.
• Despite the fact that Phototherapy has not
been explored to its full potential in the
control of STIs, it has already demonstrated
good clinical response rates and lower
recurrence rates in genital infections.
PHOTOTHERAPY

(A) Treatment of multifocal disease based on 5-aminolaevulinic acid (ALA)-PDT, effective in treating HPV
lesions. The PDT can be also used for selective and specific destruction of subclinical bacteria and fungui-
infected areas, as in the case of N. gonorrhoeae and C. albicans.
(B) The combination of water-filtered infrared A (wIRA) with visible light VIS (wIRA/VIS) is used for killing
intracellular and extracellular Chlamydia trachomatis strains in Vero and HeLa cell lines. Visible light
irradiation (405 and 670 nm) also leeds to dose-dependent inhibitory effect on Chlamydia.
(C) Diagnostic approach based on an optical nano-genosensor and gold nanoparticles conjugated to a
specific oligonucleotide for T. vaginalis PCR detection.

Wang Y, Ferrer-Espada R, Gu Y, et al. Antimicrobial blue light: an alternative therapeutic for multidrug-resistant gonococcal infections? MOJ Solar Photoen Sys. 2017;1(2):38‒39. DOI: 10.15406/mojsp.2017.01.00009

• Pulsed dye laser (PDL) has been commonly
used in the treatment for viral warts.
•Although the mechanism of action for PDL
treatment for warts is not fully known, it is
thought that this method is based on the
specific destruction of superficial dilated
capillaries in warts by selective
photothermolysis of oxyhemoglobin within the
microvasculature.
•The damage of virally-infected keratinocytes by
PDL may contribute to the treatment for warts
because the human papilloma virus is heat-
sensitive
Pulsed Dye Laser
Komericki P, Akkilic M, Kopera D. Pulsed dye laser treatment of genital warts. Lasers Surg Med. 2006 Apr;38(4):273-6. doi: 10.1002/lsm.20293. PMID: 16470844.
• The application of 585-nm flashlamp-pumped pulsed
dye laser (FPDL) light represents a safe and simple
treatment option for its effectiveness being
comparable with that of conventional therapies
• The paring the keratotic component of warts with a
blade, to the extent that blood vessels are
seen without causing bleeding before PDL treatment,
is thought to provide deeper penetration of the laser
light
• Efficacy of PDL treatment for viral warts have shown
variable response rates as with other treatment
modalities.
• The reported cure rates for this method have
• ranged from 0–100%

A–F: Genital warts located on penis before treatment (A, C, E),
crust 1 week after FPDL (B), clearance 3 weeks after FPDL (D),
erosive wound 1 week after FPDL (F).

Perianal wart, before laser treatment.
Perianal wart, 2 weeks after laser treatment.
Perianal wart, 1 year after laser treatment.
Tuncel A, Görgü M, Ayhan M, Deren O, Erdogan B. Treatment of anogenital warts by pulsed dye laser. Dermatol Surg. 2002 Apr;28(4):350-2. doi:
10.1046/j.1524-4725.2002.01172.x. PMID: 11966796.

• The Thulium laser has a stable
controllability of the tissue effect
because of the high absorbance of
energy in water.
• The light is generated as a continuous
wave
• The Thulium laser has a wavelength of
2.0 um, allowing the wavelength to
match the 1.92 um water absorption
peak in tissue.
• The high density of absorbed energy at
the tissue surface leads to instant
vaporization and limits the penetration
depth to 500-2,000 mm, depending on
the power settings, which is a
reasonable depth for sufficient
hemostasis with minimal thermal injury
to surrounding tissue.
Thulium Laser
Blokker RS, Lock TM, de Boorder T. Comparing thulium laser and Nd:YAG laser in the treatment of genital and urethral condylomata acuminata in male patients. Lasers Surg Med. 2013 Nov;45(9):582-8. doi: 10.1002/lsm.22181. Epub 2013 Sep 30. PMID: 24114691.

Thulium laser treatment of condyloma acuminata on the male
genital.
A. Condylomata Acuminata of the glance of penis
B. Inspection of the meatus with a small nasal speculum shows distal
urethral condylomata acuminata
C. Coagulation of the condylomata acuminata with the thuliym laser
showing the white blanching of the lession
Blokker RS, Lock TM, de Boorder T. Comparing thulium laser and Nd:YAG laser in the treatment of genital and urethral condylomata acuminata in male patients. Lasers Surg Med. 2013 Nov;45(9):582-8. doi: 10.1002/lsm.22181. Epub 2013 Sep 30. PMID: 24114691.

Laser Therapy. Erich E. Kung. Dermatoiogie am Hauptbahnhof, Zurich, Schweiz

Type of laser Reported reccurrence rates (%)
CO2
19-33
Argon
35
Pulsed dye
5-23
Holmium Unknown?
Nd:YAG 0-60
Thulium 33
Blokker, Rudy & Lock, Tycho & Boorder, Tjeerd. (2013). Comparing Thulium Laser and Nd:YAG Laser in the Treatment of Genital and Urethral Condylomata Acuminata in Male Patients. Lasers in
surgery and medicine. 45. 10.1002/lsm.22181.
Reccurence Rates for Treatment of Condyloma Acuminata

Laser Therapy Data on Genital Warts Treatment in Literature

Take Home Messages
Despite the range of treatment options available, energy based device has been able to achieve satisfactory
results in STDs
Further study should be conducted to identify the best therapeutic strategy in STDs.
Therefore energy based device can be considered as an alternative method for treating genital lesions in STDs,
with satisfactory results in terms of pain, aesthetic and minimal recurrence
It can be done in outpatient clinic with local anesthesia so can get ride from side effect of general anesthesia and postoperative pain. Good
dermatological outcomes aid to further improve patient satisfaction

7. dr Haykal - Energy Based Device on Sexually Transmission Diseases (STD).pdf

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