CERVICAL CRYOTHERAPY

Surgery Overview

Cryotherapy destroys abnormal tissue on the cervix by freezing it. Cryotherapy will also destroy some normal cervical tissue along with the abnormal tissue that is destroyed. Normal cells grow back over the following 6 to 8 weeks. The procedure should be scheduled in the first two weeks after your period starts.

Cryotherapy causes little or no discomfort because the extreme cold on the cervix acts like an anesthetic numbing medication is rarely needed. Most women feel a sensation of cold and a little cramping, and sometimes a sense of warmth spreads to the upper body and face. Some women may experience mild cramping throughout the day following the procedure. Repeat treatments of cryotherapy may be necessary to remove all abnormal tissue.

Cryotherapy is not adequate treatment if abnormal cells are high in the cervical canal (opening leading up into the womb); in this case, another treatment, such as a cone biopsy by LEEP will be recommended instead of cryotherapy.

How it is done

Cryotherapy is done in our office as an outpatient procedure. You will need to take off your clothes below the waist and drape a paper or cloth covering around your waist as you did for your pap test or for the Colposcopy examination. As for the other tests, you will lie on your back on the examination table with your feet in the stirrups. Your doctor will again insert a speculum into your vagina so the cervix can be well visualized.

During the procedure, liquid nitrogen circulates through a metal probe placed on the abnormal tissue. You will hear a soft hissing sound caused by the liquid nitrogen gas circulating in the probe. The liquid nitrogen provides the freezing temperatures needed to destroy the abnormal cells. This freezing will take several minutes. The cervix is then allowed to thaw and then will be refrozen for another several minutes.

Why It Is Done

Cryotherapy is done when abnormal Pap test results have been confirmed by colposcopy. If the results of the endocervical curettage do not show abnormal tissue high inside the cervical canal, then cryotherapy can be used to treat the abnormal tissue seen during colposcopy.

How Well It Works

Cryotherapy is an effective method for destroying abnormal cervical tissue, depending on the size, depth, and type of abnormal tissue. Cryotherapy destroys all of the abnormal tissue in more than 85% of cases.

Risks

Destruction of the abnormal tissue will not be complete if the abnormal cells are too deep in the cervical tissue, or if the instrument used does not completely cover the abnormal cells.

What To Think About

None of these treatments should cause any problems with sex, getting pregnant or giving birth. Cryotherapy is not a treatment for cervical cancer.

How To Prepare For Surgery

We will ask you to take 800 mg. of ibuprofen or Motrin the evening prior to your appointment, and again every 6 hours prior to your appointment time the day of your procedure to help with any possible cramping you might have with the cryotherapy.

What To Expect After Surgery

Most women are able to return to their normal activity level the day after the cryotherapy procedure.

After cryotherapy

bulletA watery vaginal discharge will occur for about 3 weeks.
bulletYou may have some spotting for the first 2 to 3 days after the procedure.
bulletSanitary napkins should be used instead of tampons for 2 weeks you will probably need to change these 6 to 8 times per day.
bulletSexual intercourse should be avoided for 2 weeks to prevent infections and bleeding.
bulletDouching should not be done for 2 weeks for the same reasons.
bulletYour first period after the treatment will probably be heavier than normal as the watery discharge may mix with your normal menstrual flow.

When to call your Doctor

Call your Doctor if you have any of the following symptoms:

bulletA fever
bulletModerate to heavy bleeding after the first three days (more than you would usually have during a menstrual period)
bulletIncreasing pelvic pain
bulletBad-smelling or yellowish vaginal discharge, which may indicate an infection

After Care Instructions

You will need regular follow-up pelvic exams after you have cryotherapy. Your first follow-up examination will include a Pap smear and will be scheduled in four months. If this first pap smear is normal, then they will be repeated every three months for one year and every six months the second year if each pap smear test is normal. After this 2 year schedule yearly pap smears are again recommended.

KEEPING YOUR FOLLOW -UP APPOINTMENTS IS THE MOST IMPORTANT PART OF YOUR CARE

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