[Consequences of laser CO2 treatment of cervical intraepithelial neoplasias on the anatomic and functional integrity of the cervix]

Abstract

Objectives: Retrospective study to analyse objectively the effectiveness and anatomic and functional consequences for the cervix of conservative CO2 laser treatment for cervical intraepithelial neoplasia.

Patients and methods: Analysis of therapeutic effectiveness and anatomic consequences of 1,114 treated patients followed at our colpolaparotomy surgery clinic for cervical dysplasia since 1987. Evaluation of function consequences by comparison with a group of patients who delivered after laser CO2 therapy for dysplasia (n = 56) and a group of control patients (n = 95) with a similar type of dysplasia after delivery and no treatment. The clinical course of the pregnancy and delivery were compared between the groups in search for risk of prematurity.

Results: Good preservation of cervical anatomy was achieved after a rigorous treatment protocol only applicable with CO2 laser. The preservation of the junctional zone facilitated diagnosis of recurrence. The risk of prematurity was low. Therapy was successful in 93.4% of the cases.

Conclusion: The choice of conservative therapy is essential, not only when the patient desires a pregnancy but also in others since preserved anatomy facilitates diagnosis of recurrence. This findings implicate the need for an unagressive energy source and also accepting the early diagnosis and treatment.