Management of 633 cervical intraepithelial neoplasias by CO2 laser: persistent diseases and recurrences.

During the past 6 years, we have managed 633 cervical intraepithelial neoplasias with the CO2 laser. If the lesion is located on the ectocervix, the CO2 laser is used to vaporize it under the microscope. If the lesion is located in the endocervical canal, the CO2 laser is used to excise a cylinder-shaped tissue with a handpiece. Colposcopic examination is performed 21 days after treatment. Persistent disease is recognized at this examination; healing is obtained spontaneously in 66% of those with persistent disease without second treatment. There were eight with recurrent disease with abnormal Pap tests and abnormal colposcopic findings, and 12 with recurrent disease with abnormal Pap tests and normal colposcopic findings (recurrent koilocytis cells). After laser treatment cervical function was good and pregnancies were normal.