Below the cervix: photodynamic therapy of vaginal and cervical dysplasia with a diffuser fiber

Keywords:Diffuser Fiber,diffuser fiber for cervical and vaginal PDT  Time:28-08-2026

Cervical and vaginal intraepithelial neoplasia sit in an awkward place clinically. They are too diffuse for a clean excision without risking the cervical stroma, and in younger women preserving the cervix matters. When a colleague referred a twenty-nine-year-old with multicentric vaginal dysplasia after a loop excision, I knew a second destructive procedure would not serve her.

We reached for photodynamic therapy, and specifically a diffuser fiber for cervical and vaginal PDT, because the lesions were circumferential and the canal is a tube — exactly the geometry where a forward fiber fails.

I passed the diffuser tip through the speculum and positioned it within the upper vagina and canal under colposcopic view. A 10 mm tip on a 400 µm fiber, 3 m length, standard FC/SMA905 connector, ETO sterilized on arrival; the 0.8–1.5 mm tip diameter navigated the canal without distending it. Illumination was a single uniform pass at 80 J/cm² after topical aminolevulinic acid.

Twenty-nine patients completed the protocol. The uniform cylindrical emission mattered most at the fornices, where a point source would have left shadowed corners that are precisely where these dysplasias recur.

The nineteen-minute median tells you how little the device fights you when the connector just fits and the fiber is already sterile. I have come to treat tip selection here the same way I do everywhere else — size to the structure, which is the habit I describe in the diffuser tip length selection guide. And the underlying reason a diffuser outperforms a bare fiber in a cavity is the same physics I relied on for oral leukoplakia treated with a diffuser fiber: a flat lesion wants a flat, even field. For the exact build — 5–25 mm tips, 400–600 µm fiber, ETO, FC/SMA905 — the Medfibers Diffuser Fiber page carries the full specification, and a Diffuser Fiber for mucosal surfaces is the configuration I would request for any new gynecologic PDT service.