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Cryotherapy of the Cervix

What Is It?

Cryotherapy of the cervix (also called cryoconization) is a treatment for certain diseases of the cervix. The procedure is preformed by freezing the outside of the cervix with a small silver instrument (about the size of a quarter), through which liquid nitrous oxide is circulated at -60 C.

How Does It Work?

Cryotherapy is a fast freezing process, which causes the fluids inside cells to turn into ice crystals, which then rupture the cells. This process is similar to skin damages by cold in winter or "frostbite." The superficial cells (normal and abnormal) are destroyed to a depth of about 1/3 inch. A scar then forms over the treated area and is later replaced by normal healthy cells.

Why Is Cryotherapy Done?

This procedure is used to treat conditions of the cervix, which cause abnormal Pap smears including Condyloma or Human Papilloma Virus (HPV) infections and Cervical Dysplasia. It also sometimes used to treat other benign problems of the cervix. Cryotherapy is considered to be the easiest and least expensive treatment for most causes of abnormal Pap smears.

Is It Painful?

Freezing of the cervix requires no anesthetic and is not painful. Most women experience only a feeling of mild cramping and are aware of a cold sensation in the vagina. We recommend that you take two Advil (Ibuprofen) or Aleve tablets one hour before your appointment for cryotherapy to control any cramping that may occur.

What are the Complications?

Cryotherapy replaces several surgical procedures on the cervix, which were previously done in the hospital. It is considered much safer than previous methods. Rare complications include infection in the uterus and tubes (especially if present prior to the procedure) and stenosis or narrowing of the cervical opening. Cervical stenosis is not a serious complication and does not interfere with fertility or menstrual periods, but can require special experience to perform adequate Pap smears in the future.

Are There Any Side Effects?

Most women will experience a profuse, watery discharge for several weeks as the cervix is healing. This discharge may have a foul odor and you will be given a prescription for a sulfa antibiotic cream to reduce the amount of bacteria (and therefore odor) if this becomes a problem. Some women experience cramps for 1-3 days after the procedure and vaginal spotting or light bleeding for several weeks is not unusual. You make take Tylenol or Advil if necessary.

What Can I Do?

You may use pads and take baths but do not douche, use tampons, or have intercourse for 3-4 weeks in order to prevent infections. Other activities, including swimming, exercise, etc. should be normal. It is important to use condoms for intercourse until your partner has negative examination or has been cleared of all HPV lesions.

Does Cryotherapy Always Work?

Cryotherapy will completely cure cervical dysplasia or Condyloma in 80% of cases. Another 10% will be cured by a second treatment. Ten percent of women will have disease requiring future therapy. You must return for a follow up visit four weeks and again repeat a Pap smear at four months. We recommend repeat every three months for the first year, then every six months for the next two years. If these are all normal you can return to regular annual GYN visits.