[CO2 laser coagulation of benign changes of the portio vaginalis in comparison with the endocoagulation technic...

The CO2-COHERENT laser was therapeutically used by the authors on 31 cases of extensive erythroplakia associated with recurrent and therapy-resistant fluor formation and on cases of highly vascularised transformation zones with contact bleeding. The benign nature of the findings first had been established by repetitive Pap smears and thorough colposcopic examination. The authors suggest that for the time being the CO2 laser is not suitable yet for the treatment of dysplasia or carcinoma in situ, since no material for histological testing is obtainable from that therapeutic approach, and the presence of microcarcinoma with invasive growth cannot be ruled out with absolute safety. CO2 laser treatment was undertaken without hospitalisation of patients, just as endocoagulation of the vaginal portio was carried out on an outpatient basis. Postoperative follow-up checks have been made one, three, and six weeks as well as three and six months from treatment. The therapeutic results obtained from CO2 laser therapy were compared with those recorded from patients who had undergone endocoagulation of the vaginal portio, with the view to checking the advantages claimed for laser therapy in the literature [1, 4, 11, 12, 23, 24], such as no need for anaesthesia, effective destruction of much of the pathological tissue, high-accuracy identification of tissue for destruction by means of colposcopy, low rate of postoperative complications, soon healing, and good haemostatic action. All these advantages were found to be obtainable just as well from the technique of endocoagulation without the need for the great amount of technical input and equipment definitely required for laser therapy [16, 18, 19, 20, 21].