Cryocautery or cryosurgery is a procedure that uses very cold temperatures to treat abnormalities of the female genital tract in addition to other areas of the body such as the skin. Very cold temperatures cause tissue destruction just as very hot temperatures do (a burn).
The advantage of using a very cold temperature is there is much less discomfort than with hot temperature. The most common reasons for performing a cryocautery in gynecology are
- abnormalities of the cervix as demonstrated on Pap smear or colposcopy,
- resistant infections of the cervix, and
- Severe cervical erosion (tissue that may cause cervical bleeding or heavy discharge).
- Lesions in the vagina and also on the skin just outside the vagina.
How is cryocautery of the cervix performed?
A speculum is inserted into the vagina as if the patient was going to have a Pap smear. A small instrument with a metal tip is then placed against the cervix (or vagina) and liquid nitrous oxide is circulated through the metal tip. The circulating nitrous oxide causes the extremely cold temperature in the metal tip this is transferred to the cervix or vagina.
The freezing is done for approximately 2 to 5 minutes, and then the cervix or vagina is allowed to thaw for an equal length of time. The freezing is repeated a second time in order to give the best chance of removing the abnormal tissue.
If the cryocautery is being performed for a cervical abnormality, the patient will be advised to have a repeat Pap smear in three to four months to assure that the lesion or abnormality has not returned.
What are the effects and after-effects of the cryocautery?
During the procedure itself, most patients say they feel a mild pressure or mild menstrual-like cramping in the lower part of their abdomen. Some patients state they feel absolutely no discomfort at all, and in very rare cases, the patient will say that the procedure is quite uncomfortable.
Many physicians recommend taking medication such as ibuprofen 30 to 60 minutes before the procedure to reduce the cramping. After the procedure is completed, the patient may expect a very heavy, watery discharge which at sometimes may be bloody. This discharge may last up to one month.
As long as the patient is having the discharge, it is important that the patient drinks plenty of liquids, so she does not become dehydrated.
The patient will most likely want to wear a mini pad while she is having the discharge. Rarely, a patient will say that she has moderate to severe cramping several days after the procedure.
If this is a problem for the patient, it is suggested that she should take ibuprofen or a similar medication that the patient would normally take for menstrual cramps. If this is not adequate to eliminate the discomfort, one should call her physician.
Because of the heavy discharge and the effect of the cryocautery on the cervix or vagina, it is advised that the patient abstains from intercourse for approximately two weeks.