CO2 laser used for cancer in situ/Bowen's disease (VIN) and lichen sclerosus in the vulvar region

The subject of this report is a surgical method, CO2 laser, for the treatment of non-invasive vulvar diseases. The combination therapy consists of skinning resection of the vulva of the central lesions and skin destruction by laser evaporation of the peripheral lesions. Over a period of five years 23 patients were treated with skinning laser resection of the vulva. Primary closure of the wound was performed in all cases. In three of the patients--two with the diagnosis of lichen sclerosus and one with Bowen's disease--who were first treated with total skinning vulvectomy, the histopathological examination revealed invasive cancer. They were treated again with total radical vulvectomy. In all cases less than 200 ml blood was lost at the time of surgery. The average duration of the operations was 25 minutes. The central section healed within eight to twelve days. All the patients with VIN were cured after the first radical treatment. The follow-up time is two to six years.