Carbon Dioxide Laser Surgery for Abnormal Cervical Cell Changes
Surgery Overview
A
carbon dioxide (CO2) laser beam is used to:
- Destroy (vaporize) abnormal
cervical tissue that can be seen through a magnifying
viewing instrument (colposcope).
- Remove abnormal tissue high in the
cervical canal that cannot be seen through the colposcope. The CO2 laser can be
used to do a
cone biopsy (see
cone biopsy for abnormal Pap test).
Laser vaporization takes 10 to 15 minutes. The abnormal
tissue is destroyed or removed, leaving normal tissue intact.
How it is done
Carbon dioxide laser surgery can be
done in your doctor's office, a clinic, or a hospital as an outpatient
procedure (you do not have to spend the night in the hospital).
You will need to take off your clothes below the waist and drape a paper
or cloth covering around your waist. You will then lie on your back on an exam
table with your feet raised and supported by footrests (stirrups). Your doctor
will insert an instrument with curved blades (speculum) into your vagina. The
speculum gently spreads apart the vaginal walls, allowing the inside of the
vagina and the cervix to be examined.
The procedure is usually
done with a numbing medicine injected into the cervix (cervical block). If a
cervical block is used, an oral pain medicine may be used along with the local
anesthetic.
What To Expect After Surgery
Most women are able to return to normal
activity within 2 to 3 days after surgery. Recovery time will depend on how
much was done during the procedure.
After laser surgery
- A watery vaginal discharge may occur for
about 2 to 3 weeks.
- Pads should be used instead of tampons for 2 to
3 weeks.
- Sexual intercourse should be avoided for 2 to 3
weeks.
- Douching should not be done.
When to call your doctor
Call your doctor for any
of these symptoms:
- A fever
- Heavy bleeding (more than
you would usually have during a menstrual period)
- Increasing pelvic
pain
- Bad-smelling or yellowish vaginal discharge, which may point
to an infection
Why It Is Done
Carbon dioxide laser surgery is done
when:
- Abnormal cell changes found on a Pap test have
been confirmed by
colposcopy and
cervical biopsy, and the abnormal cells are visible
through the colposcope.
-
Moderate to severe cell changes are
found on a Pap test. If these abnormalities cannot be confirmed by colposcopy,
cells may be collected from high up in the cervical canal by cervical biopsy.
If the abnormal cells are high in the cervix, the CO2 laser can be used to do a
cone biopsy to remove abnormal tissue.
How Well It Works
Carbon dioxide laser surgery is
successful in destroying abnormal tissue in about 95% of cases when it is used
to vaporize the tissue. When it is used to remove a wedge of abnormal tissue,
it is successful in over 93% of cases.1
Risks
- A few women may have some cervical bleeding up to 7 to 10 days
after laser surgery.
- A few women may have serious bleeding that
requires further treatment.
- Infection of the cervix or uterus may
develop (rare).
- Narrowing of the cervix (cervical stenosis) that
can cause infertility may occur (rare).
What To Think About
Carbon dioxide laser surgery is
able to destroy or remove abnormal tissue that is too high in the cervix to be
destroyed with cryosurgery.
A carbon dioxide laser can be used to
perform a cone biopsy (conization) but is not used as frequently as other
conization methods because:
- It requires more specialized training to
perform.
- A larger amount of tissue is burned at the margin of the
biopsy.
- It is more expensive.
If you have carbon dioxide laser surgery, you need regular
follow-up Pap tests. You should have a Pap test in 4 to 6 months or as often as
recommended by your doctor. After several Pap test results are normal, you and
your doctor can decide how often to schedule future Pap tests.
Complete the surgery information form (PDF)(What is a PDF document?) to help you prepare for this surgery.
References
Citations
-
Garcia F, et al. (2012). Intraepithelial diseases of the cervix, vagina, and vulva. In JS Berek, ed., Berek and Novak's Gynecology, 15th ed., pp. 574–618. Philadelphia: Lippincott Williams and Wilkins.
Credits
|
By
|
Healthwise Staff |
|
Primary Medical Reviewer
|
Sarah Marshall, MD - Family Medicine |
|
Specialist Medical Reviewer
|
Kirtly Jones, MD - Obstetrics and Gynecology |
|
Last Revised
|
December 28, 2010 |
Last Revised:
December 28, 2010
Garcia F, et al. (2012). Intraepithelial diseases of the cervix, vagina, and vulva. In JS Berek, ed., Berek and Novak's Gynecology, 15th ed., pp. 574–618. Philadelphia: Lippincott Williams and Wilkins.