What Is The Use Of Lugol's Solution Post LEEP Surgery?

Posted on Tue, 3 Mar 2015

Question: Why would a doctor use sulfuric acid and nitric acid (Lugol's solution) to stop bleeding after LEEP she it is totally caustic. my vaginal received a chemical burn on the inside and for a 1 cm area all around the entrance externally after the solution fell out immediately ehen I stood up post procedure. I spent awhile trying to rinse off with wet tissue in the room and still had intense burning and stinging on the way home and luckily had a wet wipe to put down there and screamed and yelled. I got relief from a bath and aquaphor but then have to put it on again every time before and after I pee. I found that the tissue was destroyed and stained brown for the iron in the solution when I looked in mirror. The doctor and nurse I called to report seemed to think I must have had an allergic reaction and didn't seem to have a clue that they are using a caustic acid that would obviously cause tissue destruction if allowed to touch tissue. Why would they even use a non FDA thing and why would they not take care to be sure it was blotted dry after applying to cervical or rinsed well or something. I just can't imagine there is not something less damaging to use in 2015. I wonder if the staining will be permanent and if the damaged skin will no longer be moist and will always be uncomfortable. And I wonder if this is a malpractice issue. I want this never to be used in XXXXXXX again.
I am a nurse

Answered by Dr. Kathy Robinson (30 minutes later)

Brief Answer:
Lugol's Solution

Detailed Answer:
Hello and thank you for your question.
I am sorry that you had such a bad reaction to this compound. I think that it must have been an allergic reaction, probably to iodine.
Lugol's solution does not contain surfuric acid or nitric acid. It contains elemental iodine and potassium iodide. It is used during colposcopy and LEEP procedures because normal tissue is stained by the solution but cancer cells are not stained by it and the gynecologist can then more accurately target cancer cells for removal.
It does stain normal tissue but the staining is not permanent. The damaged tissue should heal in time to its normal state. I do not think this is a malpractice issue. Lugol's is used frequently by gynecologists and I do not think they could have predicted that you had an iodine allergy.
I hope you recover from this unfortunate situation soon.
Be very careful to add iodine as an allergy to your medical record.
Regards,
Dr. Robinson

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Kathy Robinson (23 minutes later)

Although ligol's solution was used, I have written the incorrect term for my question. I had looked that up too but I believe the reaction I had was from the
Monsel's. Ligol's has been used on me at least 4 times and no prob. Not allergic to iodine for sure. So sorry I put the incorrect term. Could you please look at the question again with the monsel's solution that the doctor told me was used to further control bleeding.

Answered by Dr. Kathy Robinson (30 minutes later)

Brief Answer:
Monsel's solution

Detailed Answer:
Hi again,
Again I am sorry that you had such a terrible reaction.
Monsel's does contain ferric subsulfate and it is prepared with some sulfuric acid and nitric acid. The amount of acid in this preparation is not associated with chemical burns. It is the combination of the iron with the acids that causes hemostasis. It has been used for by gynecologist for decades to stop bleeding after procedures, usually with no ill effects.
Since you had such a severe reaction it does seem that you must have had some sort of allergic reaction.
It can definitely be irritating to the vaginal tissues causing some redness and swelling but this usually resolves quickly.
I doubt you could make a case for malpractice since this compound is use so frequently by gynecologists without problems.
I hope you are recovered fully soon.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Kathy Robinson (33 minutes later)

Is it possible that blotting of excess or rinsing should have been done? If it melts tissue to stop bleeding, is it so hard to believe that any tissue it touches would react in the expected way.
Why is it not even approved by the FDA
That is for your help

Answered by Dr. Kathy Robinson (21 minutes later)

Brief Answer:
does not melt tissue

Detailed Answer:
Hi again,

Monsel's does melt tissue. It causes hemostatsis by the breaking down of ferric ions and the agglutination of protein causing the small blood vessel to seal. They leave it in place so that it will continue to work once you get up and walk around which could result in more pressure on the vessels and more bleeding.

Again, other than a mild irritating effect on surrounding tissues, it usually does not have any adverse effects on normal tissue. Your reaction to this compound was unusual.

It has been used so long by gynecologists that it has not had the studies required by the FDA for approval. This happens with many medications that have been used for a long time. But you can report this side effect to the local pharmacovigilance department in a nearby hospital or FDA.

Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.

Above answer was peer-reviewed by : Dr. Vaishalee Punj