Vaginal laser surgery

Vaginal epithelial lesions including endometriosis, cysts, septae, human papillomavirus (HPV) disease, and vaginal intraepithelial neoplasia (VaIN) can be successfully treated by laser surgery. The carbon dioxide laser with a wavelength of 10,600 nm is the ideal laser for these clinical applications. Pretreatment evaluation using colposcopically directed biopsies is mandatory. Adherence to surgical techniques including the selection of a delivery system, control of thermal injury, depth of destruction and bleeding, as well as determination of treatment margins and therapeutic endpoints are critical for optimal clinical outcome. After treatment of HPV disease and VaIN, long-term follow-up is essential for this group of patients who are at risk for invasive cancer.