Laser treatment of cervical and vaginal neoplasia

The conservative management of cervical intraepithelial neoplasia (with electrodiathermocautery and cryosurgery) is unsuitable for the treatment of similar vaginal lesions because of complications of scarring, stenosis, and fistulas. A new modality of treatment with the use of a carbon dioxide laser beam was evaluated for the treatment of cervical and vaginal intraepithelial neoplasia. Histopathologic examination of cervical tissue after laser beam therapy showed that most of the tissue destruction resulted from evaporation of tissue and that the zone of tissue necrosis was much less than after cryosurgery or electrocautery. Laser therapy was used in 50 patients, 46 of whom had varying degrees of cervical and vaginal intraepithelial neoplasia. Treatment failures occurred in five patients (10 per cent). The experience of this study suggests that the major value of laser treatment of the lower genital tract will be in the management of vaginal intraepithelial lesions, while similar results in the treatment of cervical neoplasia may be achieved by much simpler methods.