title: Feasibility of office CO2 laser surgery in patients affected by benign pathologies and congenital malformations of female lower genital tract.
abstract: OBJECTIVE
  Traditional surgery presents some disadvantages, such as the necessity for general anesthesia, hemorrhage, recurrence of pathology, and the possible onset of dyspareunia due to an excessive scarring. CO2 laser surgery might resolve these problems and might be employed in a wider range of clinical indications than usual. We examined the results of CO2 laser surgery in patients affected by benign pathologies and congenital malformations of the female lower genital tract.
  
  
  METHODS
  In this observational study, we enrolled 49 women who underwent CO2 laser surgery for the following indications: Bartholin's gland cyst, imperforate hymen, vaginal septum, Nabothian cyst, and vaginal polyps. Feasibility, cost-effectiveness, complication rate, recurrence rate, short- and long-term outcomes were assessed.
  
  
  RESULTS
  All procedures were carried out in a short operative time, without any intraoperative complications. Only 1 (2.0%) out of 49 patients required a hemostatic suture for bleeding. Postoperative period was uneventful in all patients, except 6 (12.2%) out of 49 patients who reported pain one day after surgery, successfully treated with paracetamol. Healing was rapid and excellent in all cases; no wound infection, scarring or stenosis were noticed. Preoperative symptoms reduced or disappeared in all cases. No recurrence was observed and no re-intervention was needed.
  
  
  CONCLUSIONS
  CO2 laser surgery provides several advantages over traditional surgery, as its systematic use in treating pre-invasive, benign, and congenital pathologies of the female lower genital tract reduces patient discomfort, improves short- and long-term outcomes, and optimizes cost-effectiveness.
authors.affiliation: Surgical and Medical Department of Translational Medicine, Sant'Andrea Hospital, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy. federicamanzara@gmail.com.
authors.forename: A
authors.initials: A
authors.lastname: Frega
authors.forename: A
authors.initials: A
authors.lastname: Verrone
authors.forename: M
authors.initials: M
authors.lastname: Schimberni
authors.forename: F
authors.initials: F
authors.lastname: Manzara
authors.forename: E
authors.initials: E
authors.lastname: Ralli
authors.forename: A
authors.initials: A
authors.lastname: Catalano
authors.forename: M
authors.initials: M
authors.lastname: Schimberni
authors.forename: F
authors.initials: F
authors.lastname: Torcia
authors.forename: G
authors.initials: G
authors.lastname: Cozza
authors.forename: P
authors.initials: P
authors.lastname: Bianchi
authors.forename: R
authors.initials: R
authors.lastname: Marziani
authors.forename: A
authors.initials: A
authors.lastname: Lukic
mesh_terms: D000293:Adolescent; D000328:Adult; D000553:Ambulatory Care / Q000379:methods; D001472:Bartholin's Glands / Q000473:pathology / Q000601:surgery; D000013:Congenital Abnormalities; D003560:Cysts / Q000175:diagnosis / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D005836:Genitalia, Female / Q000002:abnormalities / Q000473:pathology / Q000601:surgery; D006801:Humans; D006924:Hymen / Q000002:abnormalities* / Q000601:surgery; D053685:Laser Therapy / Q000379:methods*; D054020:Lasers, Gas / Q000627:therapeutic use*; D008599:Menstruation Disturbances / Q000175:diagnosis / Q000601:surgery*; D009819:Office Visits; D011127:Polyps / Q000175:diagnosis / Q000601:surgery*; D014621:Vagina / Q000002:abnormalities / Q000473:pathology / Q000601:surgery*; D055815:Young Adult