A laser is an instrument that emits light (electromagnetic radiation) that is amplified by stimulated emission.
The term laser comes from the anglo-american acronym“Light Amplification by Stimulated Emission of Radiation”
The laser emits a light that is spatially and temporally coherent,and so powerful it becomes a source of heat that can “burn” the tissue the laser is focused on.
In gynecology, practitioners use the CO2 LASER because it travels efficiently through the air in a very narrow beam allowing extremely precise tissue “burning” both on the surface and/or at deeper levels.
It is very effective in the treatment of lesions of the cervix, the vagina, the vulva, and the perineum.
When treating cervical lesions the laser vaporizes cells in the path of its beam destroying abnormal cells that can be precisely seen through a colposcope.
Lasers vaporize cells in the path of its light beam. Thus when treating cervical lesions:
- the lesions are viewed through a colposcope
- the laser light beam is directed at the surfaces requiring destruction and they are instantly vaporized
- When the surfaces have been treated the laser beam is switched off
With this method one can manage how deep into the tissue the beam should travel in order to destroy all of the lesion whilst leaving the rest of the organ intact and untouched (in this case the cervix).
The advantage of this Laser treatment is that the cell destruction is more precise than with other methods and thus the healing process is improved.
Recent studies have shown that cervical Laser treatment does not impact a woman’s child-bearing future or the risk of premature births.
How is Laser treatment performed?
- Because of the high cost involved, Laser treatment is generally conducted in a healthcare facility (a clinic or a hospital)
- Most often the procedure is conducted without any general or local anesthetic. The treatment is generally almost painless but in certain situations a local or general anesthetic may be administered for example when the lesions are widespread or located in sensitive areas or areas that are difficult to access.
- The doctor places a speculum into the vagina and then performs a colposcopy (using colourants) to clearly locate the extent of the lesions.
- The Laser is set up and using the colposcope for clear vision, the doctor directs the Laser beam precisely to the target. The doctor’s vision is kept clear via the use of a smoke suction device (that is sometimes quite noisy)
- The Laser vaporization of the cervical lesions takes about 10 minutes once the process has started
- The speculum is then withdrawn and the patient is free to go home and return to normal activity. It is not often necessary to take time off work.
- Pain should not be experienced after Laser surgery but the patient may experience yellowish or pinkish vaginal discharge which indicates healing.
- Pads should be used instead of tampons for 3 weeks.
- Sexual intercourse should also be avoided for 3 weeks.
- Douching should not be done and swimming pools avoided for 3 weeks.
- If pain is experienced in the pelvic area, or heavy bleeding occurs, the patient should immediately call the doctor who performed the Laser treatment.
- A follow up appointment should be scheduled within 3 monthsof the Laser treatment. This is to check that the lesions are gone and that the healing process is underway.
- Published studies indicate that Laser treatment does not negatively affect fertility or the quality of future pregnancies.
- With Laser treatment it is not possible to examine the destroyed cell tissue. It is therefore important to build a preoperative profile that routinely includes one or more biopsies.
- Laser treatment is not 100% effective. It is therefore necessary to schedule regular monitoring in order to verify there has been zero recurrence or any persistent HPV lesions.