Cryotherapy for abnormal cervical cell changes

Surgery Overview

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Cryotherapy destroys abnormal tissue on the cervix by freezing it. Cryotherapy destroys some normal tissue along with the abnormal tissue. During cryotherapy, liquid carbon dioxide (CO₂), which is very cold, circulates through a probe placed next to the abnormal tissue. This freezes the tissue for 2 to 3 minutes. It may be allowed to thaw and then be refrozen for another 2 to 3 minutes. A single freeze treatment for 5 minutes may also be used.

Cryotherapy causes some discomfort. Most women feel a sensation of cold and a little cramping, and sometimes a sense of warmth spreads to the upper body and face.

Cryotherapy is not adequate treatment if abnormal cells are high in the cervical canal. In that case, another treatment, such as a cone biopsy, will be recommended instead of cryotherapy.

How it is done

Cryotherapy is usually done at your health professional's office, a clinic, or a hospital as an outpatient procedure (you do not have to spend a night in the hospital).

You will need to take off your clothes below the waist and drape a paper or cloth covering around your waist. You will then lie on your back on an examination table with your feet raised and supported by footrests (stirrups). Your health professional will insert an instrument with curved blades (speculum) into your vagina. The speculum gently spreads apart the vaginal walls, allowing the inside of the vagina and the cervix to be examined.

Your health professional may use medication to numb the cervix (cervical block).

What To Expect After Surgery

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

After cryotherapy

• A watery vaginal discharge will occur for about 2 to 3 weeks.
• Sanitary napkins should be used instead of tampons for 2 to 3 weeks.
• Sexual intercourse should be avoided for 2 to 3 weeks.
• Douching should not be done for 2 to 3 weeks.

When to call your health professional

Call your health professional if you have any of the following symptoms:

• A fever
• Moderate to heavy bleeding (more than you would usually have during a menstrual period)
• Increasing pelvic pain
• Bad-smelling or yellowish vaginal discharge, which may indicate an infection

Why It Is Done

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

How Well It Works

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Cryotherapy is an effective method for destroying abnormal cervical tissue, depending on the size, depth, and type of abnormal tissue. Studies have had differing results, but cryotherapy appears to destroy all of the abnormal tissue in 77% to 96% of cases.^{1, 2}

Risks

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Destruction of the abnormal tissue will not be complete if the abnormal cells are too deep in the cervical tissue.

What To Think About

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If you have cryotherapy, you need regular follow-up Pap tests. Pap tests should be repeated every 4 to 6 months or as recommended by your health professional. Once several Pap test results are normal, you and your health professional can decide how often to schedule future Pap tests.

Cryotherapy is not a treatment for cervical cancer.

Complete the surgery information form (PDF) (What is a PDF document?) to help you prepare for this surgery.

References

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Citations

1. Martin-Hirsch PL, et al. (2006). Surgery for cervical intraepithelial neoplasia. Cochrane Database of Systematic Reviews (1). Oxford: Update Software.

2. Mitchell MF, et al. (1998). A randomized clinical trial of cryotherapy, laser vaporization, and loop electrosurgical excision for treatment of squamous intraepithelial lesions of the cervix. Obstetrics and Gynecology, 92(5): 737–744.

Credits

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Author	Shannon Erstad, MBA/MPH
Editor	Kathleen M. Ariss, MS
Associate Editor	Denele Ivins
Associate Editor	Pat Truman
Primary Medical Reviewer	Joy Melnikow, MD, MPH - Family Medicine
Specialist Medical Reviewer	Barbara S. Apgar, MD, MS - Family Medicine, Women's Health
Specialist Medical Reviewer	Ross Berkowitz, MD - Obstetrics and Gynecology
Last Updated	January 12, 2007