Abstract
<title>Abstract</title> <p> <bold>Purpose:</bold> To compare the colposcopic regression rates and genital HPV (gHPV) clearance of cervical Er:YAG laser versus expectant management (follow-up) and a silicon dioxide-based vaginal gel (DeflaGyn®) in patients with low-risk cervical dysplasia. <bold>Methods:</bold> A retrospective observational cohort study of 118 HPV-vaccinated patients with CIN1 (age >25) or CIN2 (age 25–30) attending a single gynecology clinic. Patients were allocated to one of three groups: Er:YAG laser (n=46), conservative follow-up (n=41), or DeflaGyn® vaginal gel (n=31). Primary outcomes were histological regression and gHPV clearance at 4–6 months (laser/gel) and up to 27 months (follow-up). Multivariate logistic regression identified independent predictors of HPV clearance. <bold>Results:</bold> Colposcopic regression was achieved in 91.3% of the laser group versus 64.5% in the gel group (p=0.014). Complete gHPV clearance was 52.2% (laser) versus 35.5% (gel) (p=NS, univariate). Multivariate analysis showed Er:YAG laser independently increased the likelihood of HPV clearance 3.26-fold compared to DeflaGyn® (aOR=3.26; 95% CI: 1.11–9.56; p=0.031). In the conservative follow-up group, 78% demonstrated spontaneous regression by 27 months, but 7% (n=3) progressed to CIN2/3 requiring excisional treatment. <bold>Conclusions:</bold> Er:YAG cervical laser demonstrated superior colposcopic regression and HPV clearance compared to silicon dioxide-based vaginal gel in patients with low-risk cervical dysplasia. These preliminary findings support the need for prospective randomized trials. </p>