What is carbon dioxide laser surgery?

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

• Destroy (vaporize) abnormal cervical tissue that can be seen through a magnifying viewing tool (colposcope).
• Remove abnormal tissue high in the cervical canal that can't be seen through the colposcope. The CO2 laser can be used to do an excisional biopsy.

Laser treatment takes about 15 to 30 minutes. The abnormal tissue is destroyed or removed, leaving normal tissue intact.

Carbon dioxide laser treatment works well for treating abnormal cervical tissue, depending on the size, depth, and type of abnormal tissue. In most cases, carbon dioxide laser treatment destroys or removes all of the abnormal tissue.

• A few people 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).
• The cervix may not stay closed during pregnancy (incompetent cervix). Having an excisional biopsy of the cervix may increase the risk of miscarriage or preterm delivery.

You may have some light vaginal bleeding for about a week after the treatment. You may also have some spotting or discharge for about 3 weeks. Wear sanitary pads if needed. Do not have sex or place anything in your vagina for 2 to 4 weeks after the treatment or until your doctor tells you it is okay.

Most people can return to normal activity within a week. Recovery time will depend on how much was done during the procedure.

If you have carbon dioxide laser treatment, you will have regular follow-up testing with HPV tests, Pap tests, or colposcopic examinations. Your doctor will tell you what follow-up tests you should have and when you need to have them done.

Carbon dioxide laser treatment 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 an endocervical biopsy. If the abnormal cells are high in the cervix, the CO2 laser can be used to do an excisional biopsy to remove abnormal tissue.

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 supported by footrests. Your doctor willplace a lubricated tool called a speculum into your vagina. The speculum opens the vagina a little bit, allowing the inside of the vagina and the cervix to be examined.

The procedure may be done with a numbing medicine injected into the cervix. But in some cases, you may get medicine that makes you unconscious. Or you may get medicine that makes the entire area numb.

Carbon dioxide laser treatment can be done in your doctor's office, a clinic, or a hospital as an outpatient procedure. You don't have to spend the night in the hospital.