Cervical cryotherapy is a procedure which involves freezing an area of abnormal tissue on the cervix. This tissue gradually disappears and the cervix heals. One cervical cryotherapy is usually sufficient to destroy the abnormal tissue.
Cervical cryotherapy is a standard method used to treat cervical dysplasia, meaning the removal of abnormal cell tissue on the cervix.
Cervical cryotherapy, or freezing, usually lasts about five minutes and causes a slight amount of
Biopsy— Procedure that involves obtaining a tissue specimen for microscopic analysis to establish a precise diagnosis.
Cervix— Opening of the uterus (womb) that leads into the vagina.
Colposcopy— Examination of the cervix through a magnifying device to detect abnormal cells.
Cryotherapy— The therapeutic use of cold to reduce discomfort, or remove abnormal tissue.
Dysplasia— Abnormality of development, or change in size, shape, and organization of adult cells.
Electrocautery— The cauterization of tissue using an electric current that generates heat.
Loop electrocautery excision procedure (LEEP)— Electrocautery performed to excise abnormal cervical tissue.
Pap smear— A test performed using a special stain applied on a smear taken from the cervix.
Squamous cells— Scaly or plate-like cells.
discomfort. The procedure is usually performed in an outpatient setting.
Cervical cryotherapy is done by placing a small freeze-probe (cryoprobe) against the cervix that cools the cervix to sub-zero temperatures. The cells destroyed by freezing are shed afterwards in a heavy watery discharge. The main advantage of cryotherapy is that it is a simple procedure that requires inexpensive equipment.
The cryogenic device consists of a gas tank containing a refrigerant and non-explosive, non-toxic gas (usually nitrous oxide). The gas is delivered using flexible tubing through a gun-type attachment to the cryoprobe.
Women who undergo cervical cryotherapy typically have had an abnormal Pap smear which has led to a diagnosis of cervical squamous dysplasia and usually confirmed by biopsy after an adequate colposcopic exam.
Preparation for cervical cryotherapy involves scheduling the procedure when the patient is not experiencing heavy menstrual flow. Ibuprofen, ketoprofen, or naproxen sodium may be given before cryotherapy
WHO PERFORMS THE PROCEDURE AND WHERE IS IT PERFORMED?
Cervical cryotherapy can be done in the treating physician’s office. The physician is usually a gynecologist.
to decrease cramping. If there is any doubt about the pregnancy status, a pregnancy test is performed.
Cervical cryotherapy is often followed by a heavy and often odorous discharge during the first month after the procedure. The discharge is due to the dead tissue cells leaving the treatment site, and Aminocerv cream may be prescribed. The patient should abstain from sexual intercourse and not use tampons for a period of three weeks after the procedure. Excessive exercise should also be avoided to lessen the occurrence of posttherapy bleeding.
The following risks have been associated with cervical cryotherapy:
- Uterine cramping. Often occurs during the cryotherapy but rapidly subsides after treatment.
- Bleeding and infection. Rare, but incidences have been reported.
- More difficult Pap smears. Future Pap smears and colposcopy may be more difficult after cryotherapy.
A normal result is no recurrence of the abnormal cervix cells. The first follow-up Pap smear is done within three to six months. If normal, Pap smears are repeated every six months for two years. If any, recurrences usually occur within two years of treatment. Another option is to replace the initial and each yearly Pap smear with a colposcopic examination.
If a follow-up Pap smear is abnormal, a colposcopy with biopsy is usually performed. Other treatment methods, usually the loop electrocautery excision procedure (LEEP) are then used if persistent disease is discovered.
Following the procedure, it is considered normal to experience the following:
QUESTIONS TO ASK THE DOCTOR
- How is cervical cryotherapy performed?
- Why is cryotherapy required?
- What are the risks of cryotherapy?
- Is cryotherapy painful?
- What is the purpose of my cryotherapy?
- How long will it take to recover from the surgery?
- What are the after-effects of cryotherapy?
- How much cervical cryotherapy do you perform each year?
- slight cramping for two to three days
- watery discharge requiring several pad changes daily
- bloody discharge, especially 12-16 days after the procedure
Alternatives to cryotherapy include:
- Laser treatment. A carbon dioxide laser focuses a beam of light to vaporize the abnormal cells. This technique can be used in the physician’s office with very little discomfort.
- Loop electrocautery excision procedure (LEEP). This procedure uses a fine wire loop with an electric current flowing through it to remove the desired area of the cervix. Loop excision is usually done under local anesthesia and causes very little discomfort.
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American Society for Colposcopy and Cervical Pathology. 20 West Washington St., Suite 1, Hagerstown, MD 21740. (301) 733-3640. http://www.asccp.org/index.html
National Association for Women’s Health. 300 W. Adams Street, Suite 328, Chicago, IL 60606-5101. (312) 786-1468. http://www.nawh.org
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Monique Laberge, PhD