Cryosurgery of the Cervix

What is cryosurgery of the cervix?

Cryosurgery of the cervix uses extremely cold chemicals (like liquid nitrogen or argon gas) to freeze and destroy irregular cells on your cervix. Cryosurgery of the cervix is one example of a treatment called cryotherapy. Other names for this treatment include cryoablation, cryosurgical ablation or cryo.

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

Who needs to have cryosurgical ablation of the cervix?

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.
• Abnormal cells on your cervix that can turn into cervical cancer, like cervical dysplasia.

What happens before cervical cryoablation?

Cryosurgery takes place in your healthcare provider’s office while you’re awake.

Before the procedure, your healthcare provider may or may not use local anesthesia, a medication to numb just your cervix. Occasionally, you may also receive a sedative, which helps you relax. You don’t need to be asleep under general anesthesia.

Your provider may ask that you refrain from sexual intercourse or placing anything in your vagina for 24 to 48 hours before cryosurgery.

What happens during a cryoablation procedure?

Cryosurgery is a procedure that uses chemicals to freeze and destroy cells so new ones can grow back in the same spot.

For cervical cryoablation, your healthcare provider will:

• Have you lie on an exam table with your feet in stirrups (like you do for a gynecological exam).
• Insert a speculum into your vagina. This is the same tool your provider uses during a Pap test. It opens your vaginal wall so your provider can get a clearer view of your cervix.
• Insert a hollow metal tool called a cryoprobe into your vagina. A very cold chemical (as low as -58 degrees Fahrenheit or -50 degrees Celsius) 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 cervical tissue.
• Hold the probe in place a few minutes, until the tissue freezes at about -4 degrees F (-20 degrees C).
• Remove the probe and wait a few minutes for the area to thaw, then repeat if necessary.

Is cryosurgery painful?

No, 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 immediately after.

How long does cryosurgery of the cervix take?

The procedure takes less than 10 minutes.

What happens after cervical cryosurgery?

You’ll be able to go home the same day as treatment. You don’t need to recover or wait in a recovery room. You can take over-the-counter (OTC) pain relievers if you feel any discomfort.

It’s normal to leak a watery, slightly bloody substance from your vagina beginning right after the procedure. This happens because when the frozen cells thaw out, they either get reabsorbed or flushed out through your vagina. This discharge may last up to several 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. Your provider may recommend any of the following to ensure cryosurgery removed the irregular cells.

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

What are the advantages of cryosurgery of the cervix?

Cryosurgery is noninvasive, so it involves less pain, bleeding and risk of other complications. It’s also less expensive and requires less time than other types of surgery.

It’s generally a good treatment if the irregular cells are on the surface of your cervix. If the cells cover a large area, extend toward your uterus or penetrate several layers of tissue, cryotherapy isn’t the best treatment option.

What are the risks or complications of cervical cryosurgery?

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.

What are side effects of cryotherapy for the cervix?

Side effects of cryotherapy are generally very mild. You may feel some soreness or cramping for a few hours afterward. Some people feel chilly or cold. Leaking a watery, slightly bloody substance from your vagina for several weeks afterward is completely normal.

What are the drawbacks of cryosurgery of the cervix?

Healthcare providers may have reservations about cryosurgery of the cervix in certain situations. Some of the drawbacks of cryosurgery on your cervix 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.
• It can’t penetrate several layers of your cervix.

Does cryotherapy remove 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 for analysis.

How effective is cryosurgery for cervical dysplasia?

Cryosurgery of the cervix is effective about 90% of the time, and 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?

Most people can go back to their normal routines 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.

How long does it take for your cervix to heal after cryotherapy?

It may take your cervix up to three weeks to heal after cryotherapy.

When should I call my healthcare provider?

You should call your healthcare provider right away if you have certain symptoms after cervical cryotherapy. These symptoms could signal an infection or another complication:

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

Which is better: cryotherapy or LEEP?

Healthcare providers prefer LEEP over cryotherapy. The difference between LEEP and cryotherapy is that LEEP allows your provider to send the tissue to a lab for analysis. Cryosurgery freezes and destroys the tissue, which means it doesn’t let a pathologist analyze it for cancerous cells.

A note from Cleveland Clinic

If you have unusual bleeding in your cervix, cryosurgery may be an option your provider offers. The procedure uses extremely cold chemicals to freeze and destroy irregular cells and tissue.

Unlike other methods for removing irregular cells, cryosurgery doesn’t preserve the tissue, which means your provider can’t test it. It also isn’t precise and doesn’t penetrate several layers of your cervix.

Newer technologies have replaced cryotherapy of the cervix in many areas of the world. But there are places and circumstances where it may still be an option.