Ultrasound Better Than Laser Ablation for Genital Neoplasia
Ultrasonic surgical aspiration causes less pain and scarring, with no increased risk of recurrence
WEDNESDAY, April 11 (HealthDay News) -- Ultrasonic surgical aspiration produces less postoperative pain and scarring than carbon dioxide laser ablation in patients with female genital intraepithelial neoplasias, and there is no greater risk of recurrence with the technique, according to a report in the April issue of Obstetrics & Gynecology.
Vivian E. von Gruenigen, M.D., of University Hospitals Case Medical Center in Cleveland, Ohio, and colleagues randomized 110 women with a mean age of 48.5 who had vaginal or vulvar intraepithelial neoplasia to receive carbon dioxide laser ablation or ultrasonic surgical aspiration. The investigators assessed postoperative adverse effects, pain and recurrence rates during a one-year follow-up.
Patients who received ultrasonic surgical aspiration reported less pain (as measured by a visual analog scale, 21 versus 35) and had less scarring (measured in vulvar intraepithelial neoplasia patients only) than did patients who received carbon dioxide laser ablation. Recurrence rates within the first year for both treatments were equivalent, at approximately 25 percent (relative risk, 0.96). Multiple logistic regression analysis showed age to be significantly associated with recurrence (adjusted odds ratio, 0.96).
Thus, the authors conclude, ultrasonic surgical aspiration "is the treatment of choice between the two modalities."