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 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 a cone biopsy.

Your doctor will insert a lubricated tool called a speculum into your vagina. The speculum gently spreads apart the vaginal walls. This allows the inside of the vagina and the cervix to be examined.

Laser vaporization takes 10 to 15 minutes. The abnormal tissue is destroyed or removed, leaving normal tissue intact.

What To Expect

Most people can return to normal activity within 2 to 3 days after surgery. Recovery time will depend on how much was done during the procedure. A watery vaginal discharge may occur for about 2 to 3 weeks.

Self care includes:

• Using pads instead of tampons for 2 to 3 weeks.
• Avoiding sexual intercourse for 2 to 3 weeks.
• Not douching.

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.

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.

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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).