Cauterization is an outpatient procedure that is routinely performed in the physician's office. It is also performed in outpatient surgery centers and the hospital. The woman lies on the exam table with her legs in the stirrups (lithotomy position). An instrument (speculum) is inserted into the vagina to hold it open to allow visualization of the cervix. The cervix is cleansed using a vaginal swab that is soaked in a salt solution (saline). Using a lighted, magnifying instrument (colposcope), the vagina and cervix are carefully examined for signs of inflammation or abnormal surface patterns. To allow visualization of abnormal surfaces, a solution of acetic acid is applied to the cervix. The acetic acid turns precancerous and cancerous regions of the cervix white (acetowhitening). A surface anesthetic or cervical nerve block may be administered a few minutes prior to cauterization. Cauterization is performed on any abnormal-appearing regions of the cervix. The method chosen depends on the experience of the physician, availability of necessary equipment, and extent and location of the lesion.
Electrocoagulation diathermy uses electric current to destroy tissue. The current is delivered to the tissue through needle or ball electrodes. Electrocoagulation diathermy of deep cervical tissue requires general anesthesia. The most common office procedure for these conditions is Loop Electrical Excision Procedure (LEEP). The excision is done with an electrical wire so that precise control of the excision and electrocoagulation for hemostasis are accomplished. Injection of local anesthesia is necessary for this to be done in the office setting. Sometimes general anesthesia is required.
Chemical cauterization is used to treat cervical cysts, precancerous erosions of the cervix, and cervicitis. The area to be cauterized must be dried using a cotton swab to prevent the chemical from trickling onto normal tissue. A cotton swab that has been moistened with the chemical cauterant (e.g., bichloracetic acid) is touched to the cervical lesion. Cervical cysts would be punctured before application of the cauterant. After a few minutes the cauterized area is wiped with a dry swab to remove any residual chemical. Laser cauterization (laser vaporization) is an effective treatment for all cervical dysplasias including those that are too large for cryocauterization and those that slightly extend into the cervical canal (endocervix). Because of the expense of laser cautery equipment, most laser cauterizations are performed in outpatient surgery centers and hospitals and frequently involve general anesthesia. Laser cauterization is carried out by aiming a carbon dioxide laser beam at the cervical dysplasia. Because of the fine degree of control over the depth and width of tissue destruction, the laser can precisely vaporize the dysplasia while leaving adjacent normal tissue intact. A smoke evacuator is utilized to remove smoke from the vagina. Antibiotics and analgesics are prescribed as needed. |
Source: Medical Disability Advisor