Cervical Cryosurgery: What Is It and When Is It Used?
Cervical cryosurgery, cryotherapy, or cryoablation is a procedure performed to treat problems in the cervix, related to the appearance of abnormal or precancerous cells. This is done by freezing the diseased tissue, so that the body itself eliminates it and promotes the formation of a new and healthy one.
It is especially effective when the superficial layers of the uterine lining are affected. The procedure is ambulatory, minimally invasive, and requires no recovery time.
However, some complications and side effects may occur. We’ll tell you everything you need to know.
What is cervical cryosurgery and what is it done for?
Cervical cryosurgery is also called cryotherapy. Its name has to do with the fact that cold is used and it’s performed on the cervix, which is the lower portion of the uterus, that communicates this organ with the vagina.
In general terms, it’s a procedure that’s performed to eliminate any abnormal cells that may have formed, preventing them from evolving and becoming cancerous.
In particular, in cervical cryosurgery, a frozen gas is used to destroy such tissue, which is usually liquid nitrogen. This is at a very low temperature (below -50°C, -122 F).
This treatment is used to treat a variety of gynecological conditions:
- Cervical dysplasia
- Cervical warts
- Sexually transmitted infections (STIs)
- Cervicitis (inflammation of the cervix)
- Lesions caused by human papillomavirus (HPV)
While some of these conditions aren’t as dangerous, they can cause discomfort and the appearance of symptoms, such as bleeding. In addition, dysplastic cells can become cancerous.
It should be noted that this is the procedure of choice when the problem being treated only affects the superficial layers of the cervical lining. Once the abnormal cells have been destroyed, the body should replace them with new, healthy ones.
Who is it recommended for?
Cervical cryosurgery is a treatment option if dysplasia, genital warts (condylomas) or chronic cervicitis, among other problems, are present. It’s applied only when a pap smear and colposcopy have been carried out, and abnormal cells are detected.
If there’s a pelvic infection, the procedure should be postponed until it has resolved.
Neither is it recommended when deeper tissue changes are suspected. Similarly, it isn’t considered appropriate in cases of advanced dysplasia or established cervical cancer.
Although some research indicates that it has been used successfully in pregnancy, there’s potential for complications during the third trimester. Cervical cryotherapy may cause contractions, increasing the risk of premature delivery.
Preparation prior to cervical cryosurgery
Dysplasia needs to be identified and localized, including biopsy of the tissue, in addition to cytology. Sometimes dye solutions are used to facilitate the detection of cervical abnormalities.
However, cervical cryosurgery is a painless procedure, which doesn’t require anesthesia or special preparation. However, some recommendations should be taken into account:
- When infection is present, it should be treated first
- Avoid sexual intercourse one or more days before
- Don’t use tampons, lubricating ointments, or douches.
- If you take blood thinners, you may need to stop taking them.
- It isn’t necessary to fast, although just a light meal two hours beforehand is preferable.
- Some people may feel dizzy afterwards, so measures should be taken to avoid driving.
- It’s advisable to bring sanitary pads and to urinate before the procedure.
- You should wear comfortable clothing that’s easy to take off and put on.
The specialist will determine if any special preparation is required. For example, in cases of using estrogen creams, or having had bleeding, vaginal discharge, irregular periods, or pelvic discomfort.
Read more: Can I Have Sex After a Pap Smear?
What is the procedure like?
Cervical cryosurgery is scheduled so that it doesn’t coincide with the date of the menstrual period. It’s usually carried out on an outpatient basis, in the same place. It can also be done in an operating room, but doesn’t require an incision.
The process takes place according to the following steps:
- The patient’s temperature, blood pressure, pulse, and respiratory rate are monitored
- The person undresses from the waist down and puts on a surgical gown
- The patient lies down on the gynecological table, with knees bent
- If required, in some cases local anesthesia is administered
- The physician inserts the speculum to hold the vagina open and expose the cervix
- The cryoprobe or cryotherapy gun is introduced, avoiding contact with the vaginal walls
- Cryotherapy is applied over the lesion for 3 minutes
- The probe is removed and, after a pause of about 5 minutes, the application is repeated
After the procedure, the person should remain seated or lie down for a few moments, to rest. When they feel well and the doctor authorizes it, they can leave.
Care after cervical cryosurgery
Although it’s an outpatient procedure, which doesn’t require recovery, some care should be taken after cervical cryosurgery:
- Use a sanitary pad if there’s bleeding
- When urinating, wipe gently.
- Don’t have sexual intercourse or introduce anything into the vagina (tampons or douches) for at least 2 weeks.
- Neither is it advisable to immerse yourself in swimming pools or the sea, or even bathtubs, for at least 2 weeks.
- It’s advisable to shower daily
The person can carry out his or her activities as normal – go to work, do household chores and perform low-impact exercises.
Risks and side effects
Despite the above, some side effects may be observed after cervical cryosurgery is performed:
- Feeling of chills
- Lightheadedness or fainting
- Mild to moderate cramping
- Cramping during the procedure and days after
- Bloodyvaginal discharge, even up to the first month after
On the other hand, because there’s no incision, the risks of infection are lower. But further problems, such as scar tissue formation or ulceration, are possible.
According to research, this treatment is highly effective. Patients do well in the short and long term, with no significant morbidity.
However, there are a few possible complications of cervical cryosurgery. These include pelvic infections, burning of the vaginal wall, excessive bleeding, heavy menstrual cramps, and pain during intercourse.
In rare cases, there is stenosis of the endocervical canal. This condition can make it difficult to become pregnant.
Regarding complications with regard to pregnancy, its application is not always recommended. The patient should be informed if she’s pregnant, although the procedure is discouraged at that stage.
The patient should contact her physician immediately or go to the emergency room if she experiences any of the following symptoms after the procedure:
- Vaginal bleeding
- High fever with chills
- Heavy, yellowish, foul-smelling discharge
- Cramping or acute abdominal pain
- Prolonged pelvic pain
Long-term monitoring and care
Although the procedure is highly effective, you should maintain appropriate vigilance by seeing your healthcare provider regularly. Precancerous cells can develop in other parts of the cervix.
A follow-up visit one and a half months after cervical cryosurgery is recommended, and for at least the first year after the procedure, Pap smears should be done more frequently than normal (every 3 to 6 months).
If any abnormalities are noted on evaluation, biopsies, HPV testing and other imaging studies may be required. Additional treatment may require surgical intervention if abnormal cells are still present.It might interest you...