LASER is an acronym for Light Amplification by Stimulated Emission of Radiation. The laser is a device that produces a highly concentrated beam of light which can be focused to a very small spot. This differs from ordinary light waves which spread in all directions. Light from the laser is absorbed by the selected tissue and transmits energy in the form of heat. Laser causes destruction of abnormal cells by heating the fluid inside the cell, causing it to burst and disappear in a mist of smoke (vaporization). Laser does not give off radiation like X-rays, and so it does not affect tissue it does not touch. 

There are multiple advantages associated with the use of LASER vaporization therapy. Studies have shown that this method is the most effective treatment for removal of certain abnormalities from the vulva, vagina, cervix, and perineum, such as condylomata (venereal warts) and dysplasia (abnormal pap smear). Other benefits include the following:
  • Surgery is usually performed on an outpatient basis in the office or one-day surgery center
  • Quicker postoperative recovery
  • Diminished pain
  • Decreased bleeding/discharge
  • Minimal scarring
  • Enhanced healing
  • Fewer activity restrictions
  • Virtually no adverse effects on fertility
  • Decreased rate of disease recurrence
Your physician will discuss the problem and recommendations for workup and treatment. In most cases, a colposcopy will be performed at the first visit. The colposcope is an instrument which is used to magnify the surface of the affected area. This allows the physician to identify areas of abnormal tissue which may be difficult to see with the naked eye. During a colposcopy, the instrument never touches the woman's body. The procedure is painless and usually takes less than 20 minutes. A biopsy may be taken if an abnormality is seen or suspected. A biopsy is the removal of a tiny piece of tissue (bread crumb size) from the suspicious area. Many patients experience no discomfort, but some feel a sensation similar to mild cramping. This usually resolves within minutes. Spotting after a biopsy may require the use of a sanitary napkin or minipad. A pathologist will examine the biopsy sample under a microscope. Those findings, along with your physician's evaluation, will lead to a final diagnosis and treatment plan. If LASER therapy is suggested, an appointment for surgery will be made.
 LASER Therapy
The type of laser surgery you receive depends on the site and extent of the disease. Whether you are treated in the doctor's office or surgery center, and whether you will be awake or asleep (general anesthesia) are also determined by the doctor and the diagnosis. If you are going to be awake for the procedure, you may receive local anesthesia (a "numbing" injection or gel placed at the site of the treatment) to decrease any discomfort. You will probably be placed in the "lithotomy position" (the same one your physician used to do the pap smear and colposcopy) during the laser treatment. After the procedure you will rest in the office or Recovery Room until you are ready to go home. Someone else should drive you home if you have received general anesthesia.
Post-Operative Care
General: Bleeding that resembles a normal period may occur after your procedure or may even be delayed up to 4-10 days. Light spotting or a pinkish/blood-tinged discharge may persist for up to 2 weeks. If you have bleeding that is heavier or longer than a normal period, a foul-smelling discharge, severe pain or fever of 101° Fahrenheit lasting 24 hours or more, call your health center.
Activity: Resume normal activities after 1-3 days or when you feel able to move about without discomfort. Cone biopsy or extensive vaporization requires that you avoid strenuous activity which may result in bleeding and pain. 
*If you received general anesthesia, activities that require extra concentration, such as driving, should be avoided for 48 hours.
Work: You may return to work or school as soon as you feel ready.
Diet: You may resume your regular diet as soon as you feel ready. Call your physician if you experience nausea or vomiting.
Sex: Abstain from sexual relations 2-4 weeks or as otherwise directed. If you are being treated for genital warts, your doctor or nurse may recommend that your partner also be examined by a urologist and that he use condoms when sexual relations resume.
Wound Care: If you have had surgery on the cervix or vagina, DO NOT DOUCHE, DO NOT USE TAMPONS, AND DO NOT PLACE ANY MEDICATIONS IN THE VAGINA unless otherwise instructed, for 2 weeks.
If you have had surgery on the vulva or perineum, you should DO THE FOLLOWING:
  1. Take sitz baths or soak in the tub in warm water for 15 minutes, 3 times or more per day. Add either:
    1. 1/4 cup INSTANT OCEAN (available at an aquarium or pet store);
    2. 1/4 cup epsom salts; or
    3. 1/4 cup table salt plus 1/4 cup baking soda, to approximately 3 inches of water in the tub.
  2. After soaking, cleanse the area gently with 1/4 strength Betadine (available in the pharmacy). The proper mix is 1 part betadine to 3 parts water.
  3. Use a blow dryer on the "air" setting (no heat) to thoroughly dry the area.
  4. Apply Silvadene cream or a bio-occlusive dressing if prescribed.
  5. Do not wear sanitary pads. Instead, wear all cotton underpants in a larger size than you normally wear to allow air-flow. Change 3-4 times per day or as needed.
  6. If you have discomfort while urinating, try gently squirting cool water from a squeeze bottle down the perineum into the toilet, and drink lots of fluid to keep urine dilute.
  7. Applications of a moistened tea bag for 10-30 minutes may relieve burning or pain.
  8. Your doctor may advise you to douche. Specific instructions will be given if advised.
*(2, 3, 4 - should also be done after each bowel movement.)
Medications: Most postoperative pain is not severe and may be relieved by such over-the-counter preparations as Tylenol, Nuprin, or Advil. Aspirin should be avoided, as it may increase bleeding. If your physician thinks it is necessary, he/she will write a prescription for pain relievers such as Motrin or Tylenol No. 3. Anesthetic cream (such as Xylocaine Jelly) may be prescribed for local soothing. If you are on regular daily medications that have been prescribed by a doctor, you should resume taking them.
If any of the following occurs, please call your doctor's office immediately.
  • Pain or difficulty in urination
  • Fever of 101° Fahrenheit for 24 hours or more
  • Thick, foul-smelling discharge from vagina or lasered area or heavy bleeding
  • Severe abdominal pain, unrelieved by medication
  • Increased redness, pain, swelling, or heat in the lasered area.

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