Carbon Dioxide Laser Surgery for Abnormal Cervical Cell Changes

Carbon Dioxide Laser Surgery for Abnormal Cervical Cell Changes

Surgery Overview

A carbon dioxide (CO2) laser beam is used to:

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 a lubricated tool called a 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

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.

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.

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.
  • 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 works well for destroying abnormal cervical tissue, depending on the size, depth, and type of abnormal tissue. Studies have had differing results. They show that carbon dioxide laser surgery destroys all of the abnormal tissue in 77 to 98 out of 100 cases.footnote 1 And when this surgery is used to remove a wedge of abnormal tissue, it is successful in about 93 to 97 out of 100 cases.footnote 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.

References

Citations

  1. 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

Current as ofMarch 27, 2018

Author: Healthwise Staff
Medical Review: Sarah A. Marshall, MD - Family Medicine
Kathleen Romito, MD - Family Medicine
Martin J. Gabica, MD - Family Medicine
Kevin C. Kiley, MD - Obstetrics and Gynecology

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