Cryotherapy of the Cervix

Cryotherapy uses extremely cold chemicals (like liquid nitrogen or argon gas) to freeze and destroy irregular cells on your cervix. It also goes by the names cryoablation, cryosurgical ablation or cryo.

Newer treatments have replaced cryosurgery of the cervix in many areas. Healthcare providers prefer treatments such as loop electrosurgical excision procedure (LEEP) for removing irregular cells. But there are certain places and times where it may still be a treatment option.

Your healthcare provider may suggest cervical cryotherapy if you have:

• Irregular or unexplained bleeding from your cervix
• Cervicitis or inflammation of your cervix
• Genital warts
• Irregular cells on your cervix that can turn into cervical cancer (like cervical dysplasia)

What happens during cervical cryotherapy?

Cryosurgery is a procedure that uses chemicals to freeze and destroy cells so new ones can grow back in the same spot. It takes place in your healthcare provider’s office while you’re awake. Your provider may ask that you not put anything in your vagina for 24 to 48 hours before your appointment.

Before the procedure, your healthcare provider may numb your cervix. Then, they will:

• Have you lay down on an exam table with your feet in stirrups.
• Insert a speculum into your vagina. This lets your provider see your cervix.
• Insert a hollow metal tool called a cryoprobe into your vagina. A very cold chemical flows through the probe, making it extremely cold.
• Touch the tip of the cryoprobe to the cells or tissue that need treatment. The tip of the probe will have ice crystals on it and be cold enough to freeze the tissue.
• Hold the probe in place until the tissue freezes.
• Remove the probe and wait a few minutes for the area to thaw, then repeat if necessary.

The procedure takes fewer than 10 minutes.

How painful is cryotherapy?

It shouldn’t be painful. You may feel some discomfort or light cramping, but you shouldn’t feel pain. Some people feel slightly dizzy or cold right after.

What happens after cervical cryotherapy?

You’ll be able to go home right away. You don’t need to wait in a recovery room. You can take over-the-counter (OTC) pain relievers if you feel any discomfort later.

It’s normal to leak a watery, slightly bloody substance from your vagina right after the procedure. This happens because the frozen cells thaw out. This discharge may last a few weeks. You can wear a pad to catch the discharge. Don’t use tampons.

Your healthcare provider will want to see you for a follow-up appointment to make sure the cells were destroyed. Depending on your results, your provider may recommend additional testing, like:

• Pap test
• LEEP (loop electrosurgical excision procedure)
• Biopsy

What are the benefits and risks?

Cryotherapy is noninvasive and safe. It comes with less risk compared to other treatments. It’s also less expensive and quicker than other types of surgery.

It works best when the irregular cells are only on the surface of your cervix. Cryotherapy may not be the best treatment if the cells cover a large area, spread toward your uterus or grow deeper into the tissue.

Cryoablation is generally safe, and it shouldn’t affect your ability to get pregnant later. But it may cause:

• Cramps or pain
• Vaginal spotting
• Fainting or being dizzy (most common immediately after)
• Infection or flare-up of an existing pelvic infection
• Scarring on your cervix, a condition called cervical stenosis
• Freeze burns on your cervix

When is cryotherapy not a good option?

Healthcare providers may not recommend it in some cases. Some drawbacks of cryosurgery are:

• It doesn’t allow your provider to test the tissue once they remove it because the tissue is destroyed.
• It isn’t precise, which means cancerous cells may be missed.
• It doesn’t remove severe cervical dysplasia (CIN 3), which is more likely to lead to cancer.

Does freezing the cervix get rid of HPV?

Yes. Cryotherapy can remove precancerous cells on your cervix from HPV (human papillomavirus). But it also destroys the cells in the process. This means your provider can’t send it to a lab to test it for cancer.

How effective is cryosurgery for cervical dysplasia?

Cryosurgery is effective for treating cells that may lead to cancer about 9 in 10 times. The irregular cells usually don’t come back. If they do, you may need another treatment to remove abnormal cells.

What is the recovery time?

You can typically go back to your normal routine right away. Talk to your healthcare provider about how long you should rest or if you should avoid any activities.

Your provider will recommend avoiding vaginal intercourse, using tampons or placing anything in your vagina for up to three weeks. That can help your cervix heal and prevent infection.

When should I call my healthcare provider?

You should call your healthcare provider right away if you have symptoms like:

• Fever of 100.4 degrees Fahrenheit (38 degrees Celsius) or higher
• Heavy vaginal bleeding
• Severe pain in your abdominal area
• Vaginal discharge that smells bad