The short version
- Carbon dioxide laser treats abnormal areas of the vaginal wall by removing a very thin layer of tissue.
- Vaginal biopsies take small samples so a pathologist can say exactly what an abnormal area is.
- Avoid strenuous exercise for about 1 week. No lifting over 20 pounds for 1 week. Pelvic rest for 1 week. [1]
- If Premarin cream was prescribed, apply 1 gram into the vagina every night before bed. [1]
- Brown coffee-ground discharge after biopsies is expected. It comes from Monsel's solution. [1]
Your own discharge papers come first
Everything on this page is taken from the standard printed instructions this office gives patients. If the papers you were handed at discharge say something different, follow those. They were written for your operation. When the two disagree, call the office at 817-759-7065 and let us settle it.
After a vaginal procedure
The printed instructions for CO2 laser treatment and vaginal biopsies.
What these procedures are
CO2 laser uses a focused beam of carbon dioxide light to remove a very thin layer of tissue from an abnormal area of the vaginal wall. It is precise, it seals small blood vessels as it goes, and it treats the surface without cutting into deeper tissue. It is used for vaginal intraepithelial neoplasia, or VAIN, which is an abnormal but not yet invasive change in the vaginal lining.
Vaginal biopsies take small samples of any area that looks abnormal, so a pathologist can say what it is rather than what it might be. Both are usually done in the operating room under anesthesia, and you go home the same day.
The estrogen cream
Our written instructions for this procedure say to apply 1 gram of Premarin cream into the vagina every night before bed. [1] Premarin is a topical estrogen cream. After laser treatment the vaginal lining has to rebuild itself, and estrogen applied directly helps that tissue heal thicker and more comfortably.
The applicator has markings on it. One gram is a small amount, and more is not better. If this cream was not prescribed for you, this instruction does not apply to you, and if you are not sure whether it was, call the office rather than guessing.
The coffee-ground discharge
Normal, and alarming if nobody told you
If vaginal biopsies were taken, a mustard-colored solution called Monsel's solution is usually applied to the biopsy site to stop bleeding. When it mixes with blood it can create a brown discharge that looks similar to coffee grounds. If you see this, it is normal. [1]
Recovery
- Diet. Resume your normal diet. [1]
- Pain. Cramps and soreness are normal. Ibuprofen or Tylenol as needed. Prescription medicine is for breakthrough pain. [1]
- Bleeding. Some spotting is normal. Pads, not tampons. [1]
- Exercise. Avoid strenuous exercise for about 1 week. [1]
- Lifting. Nothing over 20 pounds for 1 week. [1]
- Pelvic rest. No intercourse, no douching, nothing in the vagina for 1 week. [1]
- Driving. Not the day of surgery, not if soreness slows your reaction time, and not while taking prescription pain medicine. [1]
- Bathing. Shower when comfortable. Avoid tub baths and hot tubs for 2 weeks. [1]
- Walking. Up and walking every 1 to 2 hours in the days afterward. [1]
- Follow-up. 2 week and 6 week visits, already booked. Check the blue folder or call 817-759-7019. [1]
When to call
When to seek care right away
Call the office now, or go to the emergency department, if you have:
- A fever of 101 degrees Fahrenheit or higher
- Chest pain or shortness of breath
- Nausea and vomiting you cannot get on top of
- Bleeding through more than one pad an hour
- Vaginal discharge with a foul odor
- Trouble emptying your bladder, or burning when you urinate
- Increasing swelling in one leg
- A sudden gush of blood, or filling more than one pad an hour
After a vaginal procedure
The printed instructions given after CO2 laser treatment or vaginal biopsies.
Sources
- Vasques DR. Post Vaginal Procedure (CO2 laser, biopsies) Instructions. The Center for Cancer and Blood Disorders, Fort Worth, TX. Patient handout supplied by the practice. pdfs/after-vaginal-procedure.pdf
- National Cancer Institute. Cervical Cancer Treatment (PDQ) Patient Version. Updated April 3, 2025. https://www.cancer.gov/types/cervical/patient/cervical-treatment-pdq
Reviewed by DeEtte R. Vasques, DO, MBA · September 2026