Fractionated CO2laser treatment for pearly penile papules: evaluation of clinical results and sexual health quality of life improvements

Background Pearly penile papules (PPP) are acral angiofibromas. They are asymptomatic, benign, non-infectious lesions located on male genitalia. Although asymptomatic and non-infectious, PPP can be a source of significant psychological distress to the patient and his sexual partner with a significant alteration in the patient's sexual concern. Methods All PPP male patients who received fractionated CO(2)laser treatment between April 2017 and December 2019 were included in this study. All patients completed a self-administered survey between 3 and 12 months after treatment that evaluated changes in their sexual health quality of life (SHQL). This survey asked the respondents about previous medical consultations and proposed solutions, circumcision status, stories about embarrassing situations related to PPP, how PPP affected their sexual health, and how the fractionated CO(2)laser treatment impacted their sexual health. Results A total of 20 male patients aged 18-54 years old (average: 29 years old) that had been diagnosed with PPP were treated using a fractionated CO(2)laser. A complete clearance of PPP was achieved in all cases with minimal complications and discomfort. Overall, 70% of the enrolled patients indicated they had suffered, at least once in their life, an embarrassing sexual situation due to their PPP and 60% of them rated the way that PPP altered their SHQL as very important to extremely important. Eighty percent of patients had previously consulted with another physician. In 75% of the cases, the answer from the physicians was that PPP are benign and non-treatable lesions. Ninety percent of the patients evaluated the level of improvement in their SHQL as successful: 45% as extremely successful, 45% as very successful, and only 10% reported poor results. Conclusions Fractionated CO(2)laser treatment has demonstrated to be a safe and effective PPP treatment. PPP significantly alters young male SHQL and deserves medical treatment. The majorities of physicians minimize the psychological effects and impact of PPP in this population and are not aware of available PPP treatments. Level of evidence: Level IV, therapeutic study.