Fulguration

What is fulguration?

Fulguration (electrofulguration) is a type of electrosurgery — a treatment that uses electricity to heat and destroy abnormal cells. Like other electrosurgery, fulguration operates on a simple principle: Heat can heal. Instead of making physical cuts, or incisions, it uses electrical currents to remove atypical cells. The science behind how this process works depends on the type of electrosurgery.

With fulguration, healthcare providers use a probe with an electrode at the end to direct energy toward the treatment area. The electrode creates a spark that generates enough heat to kill the targeted cells.

Sometimes, the probe has a tiny wire loop on the end that carries the electrical current. The type of instrument your provider uses depends on the specific procedure.

What does fulguration treat or manage?

Healthcare providers use fulguration to destroy cells causing benign, precancerous or cancerous growths. Sometimes, providers use fulguration to stop bleeding after traditional surgery.

Providers use fulguration to treat:

• Urinary tract and bladder conditions. Bladder fulguration treats early-stage bladder cancer and is used after a biopsy to stop bleeding.
• Gynecological conditions. Fulguration can destroy the growths that cause endometriosis. Healthcare providers also use fulguration to treat cervical dysplasia. This treatment prevents cervical cancer by destroying precancerous cells.
• Skin conditions. Fulguration can destroy harmless skin growths, like skin tags or genital warts. Providers also use fulguration to treat precancerous growths, like actinic keratosis. Without treatment, it can become squamous cell carcinoma.

How should I prepare for procedures using fulguration?

There isn’t one set way to prepare. Be sure to follow your healthcare provider’s instructions about:

• Fasting: If (and when) you should stop eating or drinking before the procedure.
• Taking medications: Whether you’ll need to stop taking medications before the procedure.
• Returning home: Whether you’ll get to go home that same day or if you’ll need to stay in the hospital overnight.
• Driving: Whether you’ll need someone to drive you home (depends on the type of anesthesia you get).

What happens during fulguration?

The specifics of what happens varies by procedure, but general steps include:

1. Positioning and preparation. Your healthcare provider will position you on an exam table or in a chair. They’ll prepare you for the procedure. (For example, “prep” may involve cleaning the treatment area.)
2. Receiving anesthesia. You’ll receive local, regional or general anesthesia to keep you from feeling any pain.
3. Having the cells removed. Your provider will turn on an electrosurgical generator that creates high-frequency, short-wave currents. The characteristics of the current (like the frequency and wave patterns) allow it to generate heat powerful enough to burn a targeted surface layer of tissue. They’ll use a probe with an electrode to generate a spark that breaks down the targeted growths.

Fulguration in bladder cancer surgery

In bladder cancer surgery, healthcare providers use fulguration as part of a procedure to diagnose and treat tumors called transurethral resection of bladder tumor (TURBT).

Healthcare providers use a rigid instrument called a resectoscope to access your bladder and remove tumors. The resectoscope has a tiny wire loop that can carry electrical currents. Providers use the loop to surgically remove the tumor. Then, they use fulguration to destroy any remaining cancer cells and stop the bleeding.

Fulguration in cervical dysplasia surgery

Healthcare providers use fulguration as part of a procedure to diagnose and treat cervical dysplasia called loop electrosurgical excision procedure (LEEP).

Surgery involves gently inserting a speculum into your vagina so your provider can see your cervix. After injecting or placing a numbing medication on your cervix, your healthcare provider guides a loop made of thin, electrically charged wire to your cervix. The loop passes over your cervix. It cuts a thin layer of tissue containing abnormal cells with each pass.

What happens after fulguration?

You’ll need some time to recover before leaving your healthcare provider’s office or facility. With most procedures that use fulguration, you’ll get to go home that same day.

What are the advantages of fulguration?

Fulguration is a minimally invasive treatment for some conditions, which doesn’t require large incisions or cuts.

For skin conditions, fulguration often helps get rid of growths for good. Other times, fulguration can help manage the condition. For example, fulguration can destroy tissue causing pesky symptoms if you get recurrent UTIs or if you have endometriosis. It can get rid of early-stage bladder cancers, although sometimes, the tumors return.

Ask your healthcare provider about the benefits of fulguration based on your diagnosis.

What are the risks or complications of fulguration?

The most common complication involving fulguration is delayed bleeding. Your healthcare provider will tell you what to do if a wound on your skin starts bleeding. Usually, applying direct pressure for 20 minutes resolves the issue. You may notice blood in your pee after bladder fulguration and vaginal bleeding following cervical fulguration.

Fulguration, like any electrosurgery, carries some risks. But it’s important to know that providers who use fulguration complete training focused on minimizing them. Potential risks include:

• Electric shocks or fire. The risk is greatest if the fulguration equipment comes into contact with flammable material. Your provider will take care to ensure electricity and flammable materials don’t mix.
• Electric or thermal burns. Providers take preventive steps, like ensuring you don’t come in contact with metal during your procedure. They’ll only use nonflammable products to clean the treatment area.
• Infections caused by toxic gases. Electrosurgery can generate surgical smoke and blood droplets in the air that can spread germs. Providers prevent the spread of toxic gases by using smoke-evacuation systems, face masks, protective eyewear and surgical gloves.

What is the recovery time after fulguration?

Healthcare providers use fulguration for different procedures. Each has different recovery times.

Before your procedure, ask your healthcare provider what to expect after your procedure, including:

• How long it may take to heal.
• What medications you may need to take for pain.
• When you’ll need check-ups.

When should I see my healthcare provider?

Contact your provider any time you have the following symptoms:

• Fever above 101 degrees Fahrenheit (38.3 degrees Celsius).
• Unusually heavy bleeding from your surgical site.
• Intense abdominal pain.

Are cauterization and fulguration the same thing?

Cauterization and fulguration are similar in that they both use electrical currents to generate heat that destroys atypical cells. But the flow of electricity is different.

Cauterization uses a direct current (DC). This means that the current travels from the electrode to the tissue, burning it. It’s a one-way trip. Electrosurgical procedures (like fulguration) use an alternating current (AC). The current travels back and forth between tissue and electrode, generating more heat as it passes through cell layers.

The science is complex, but the type of current flow that works best depends on the treatment you need.

Is fulguration the same as ablation?

Fulguration and ablation aren’t the same, but there’s overlap. Ablation therapy uses different types of energy sources to “ablate” (get rid of) atypical cells. Energy types include microwaves, high-energy radiofrequency, lasers or extreme cold (cryoablation). Fulguration is a specific way of delivering electricity (with a probe and an electrode) to destroy atypical cells.