Cryosurgery and the CO2 laser

Over the past decade, the management of intraepithelial lesions of the visible portion of the female genital tract has substantially changed with the introduction of cryosurgery and the carbon dioxide laser. Although cryosurgery and the carbon dioxide laser are very effective in eradicating preinvasive disease, the selection of patients by colposcopy and appropriate biopsies is more important than the treatment techniques. Failure to properly evaluate women with genital tract neoplasia can result in disastrous consequences for the patient. The CO2 laser shows considerable promise in managing dysplasia and carcinoma in situ of the vagina and vulva. The laser combines the accuracy of the operating microscope and the precision and control of the photon beam. Posttreatment sequelae are minimal, and scarring is absent.