The term laser is an acronym for "light amplification by stimulated emission of radiation." The carbon dioxide laser beam is invisible but usually guided by a second laser that emits visible light. Laser therapy is used as treatment for intraepithelial neoplasia of the vulva, vagina, and cervix, including extensive or resistant condyloma.

The laser is used with a colposcope, providing the added advantage of visualizing the area of treatment and minimizing trauma to normal tissue. The energy from the laser beam is absorbed by water, with resultant vaporizaton of the target tissue.

The procedure is done in the outpatient setting. The procedure usually takes 30-60 minutes. You will be in the recovery room 1-2 hours.

Most laser surgery is done under general anesthesia. Because of this you cannot have anything to eat or drink after midnight the night before your surgery. There may be prescriptions for you to fill prior to the procedure for care of the surgical area after the surgery. You may also be asked to give yourself a Fleets enema the night before or the day of your surgery.

Severe pain usually settles within 4-12 hours after surgery. Following this, most patients experience mild to moderate discomfort that can be controlled by prescription pain relievers. Mixing crushed ice and cold water in a ziplock bag and applying the bag to the area of pain can often relieve any increase in pain. Sitting on an air cushion may also be helpful. You may experience light bleeding or brown discharge for several days after surgery.

If you have had laser to the cervix or vagina, vaginal bleeding consistent with a period will occur for approximately 10 days following the procedure. At the 10-day point, the bleeding may actually worsen for 3-4 days prior to subsiding. Also, a large plug of tissue may be passed 2-3 days following surgery in certain situations.

Depending on the treatment area, follow-up care and instructions may include:

• To aid healing and to help prevent infection, you should refrain from sexual

intercourse, using tampons, vaginal douching, public pools and hot tubs.

• All patients receiving laser vaporization of the cervix or vagina will require post-op application of antibiotic cream to be used at bedtime the day following surgery for a total of ten evenings.
• All patients receiving laser vaporization of the vulva will require a medicated ointment to be used three times a day, usually after a sitz bath.
• To help keep the area clean, you may be instructed on the use of a sitz bath. To do a sitz bath at home, place a clean towel in the bottom your tub, and run warm water continuously and lift the towel to let water out after it gets just deep enough to cover the area. Keep running the water and repeating. It is best to do sitz baths after bowel movements and urinating.
• For comfort and cleansing, use a squirt bottle filled with warm water.
• After cleansing dry area with a hair dryer on low setting.
• Avoid constipation by using a stool softener as needed and drinking 6-8 glasses of fluid a day.
• To avoid stress to the area, refrain from activities such as jogging or horseback riding, avoid prolonged sitting, and wear loose fitting clothing.

Please notify our office if you experience a fever over 101 degrees, foul smelling discharge, heavy bleeding or clots, or severe pain.

Please call the office for a follow-up appointment 12-14 days following vulvar or vaginal surgery or 21 days following cervical surgery.