Obstetrics & Gynecology

Special Programs

Infrared Coagulation (IRC) Therapy

The Infrared Coagulator (IRC) is a special instrument that delivers heat to destroy the tissue so it can be removed. The IRC was approved by the US Food and Drug Administration for treating Condyloma (warts), hemorrhoids, chronic rhinitis and tattoo removal. Now, it is used to treat internal and external anal low grade squamous intraepithelial lesions (LSIL) and high grade squamous intraepithelial lesions (HSIL). The procedure takes place in the office with minimal discomfort during and after the treatment.

IRC Procedure

Lidocaine gel (numbing medicine) will be applied before treatment. High resolution anoscopy (HRA) will be performed to locate the abnormal areas and additional local anesthetic (numbing medicine) will be injected in the areas to be treated. The IRC tip will be placed in direct contact with the abnormal area and deliver heat for 1.5 seconds. This will be repeated as necessary to treat all of the abnormal areas of the anus. You may feel some heat from the IRC. The resulting necrotic (dead) tissue will be removed. Treatment can take up to 1 hour.

Lesions are usually treated in one office visit. Additional treatment may be required for larger lesions.

After the Procedure

Recovery is fast. Avoid lifting anything more than 20 pounds for 1 week after the procedure. Avoid inserting anything into the anus for 2 weeks after the procedure (No anal sex. No toys.).

• There can be mild to moderate pain or discomfort which can be treated with pain medication (such as ibuprofen 600mg-800mg every 6-8 hours as needed) for 1-3 days.
  
  
• Frequent soaking in hot water, especially after bowel movements, can decrease the pain.
  
  
• Increasing fluid intake to avoid constipation will help minimize pain.
  
  
• Bleeding or discharge with bowel movements can occur for up to 2-3 weeks.
  
  
• Rare complications (< 1%) include infection and severe bleeding.

Call the office or go to your local emergency room if you develop severe pain, heavy bleeding, or fever of more than 101 degrees.

Follow up exam

A follow up exam is scheduled 3 months after the procedure.

For more information, please contact

Dr. Elizabeth Stier
Boston Medical Center
617.414.6375

Additional Resources

• Download (PDF)Brochure for Infrared Coagulation
  
  
  
• Anal Cancer Treatment and Therapies
  (http://id.medicine.ucsf.edu/analcancerinfo/treatment/therapies.html)
  
  
  
• Anal intraepithelial neoplasia: Diagnosis, screening, and treatment
  (http://www.uptodate.com/contents/anal-intraepithelial-neoplasia-diagnosis-screening-and-treatment)
  
  
  
• Standard Procedure for Infrared Coagulation (IRC) Therapy
  (http://www.ucsfmedicalcenter.org/medstaffoffice/Standardized_Procedures/Infrared%20Coagulation%20Therapy.pdf)