Has your doctor said there's something wrong with your Pap test? Or do you sometimes have small drops of blood coming out of your cervix? These things can make you a little scared and anxious. But don't worry. Most of the time, these things aren't serious. One simple treatment that doctors recommend in these cases is called 'cryosurgery.' Although the name may sound like a big deal, it's actually quite simple. To be precise, it involves using extreme cold, like ice, to destroy the abnormal cells. Let's talk about this in a clear and simple way.
Simply put, what is cryosurgery?
Okay, let's understand this with a very simple example. Imagine you have a small wart on your arm. Sometimes doctors use a very cold liquid to remove the wart. The cold kills the cells in the wart. The same thing happens in cryosurgery for the cervix.
What happens here is that the doctor uses a very cold chemical, such as liquid nitrogen, to 'freeze' or freeze the abnormal cells on the surface of your cervix. The extreme cold causes the cells to die. Then, our body's natural healing process allows new, healthy cells to grow in that area. This treatment is also called cryotherapy.
In the past, this method was very popular to remove abnormal cells from the cervix. But now, in Sri Lanka and many places in the world, newer, more effective methods like LEEP (Loop Electrosurgical Excision Procedure) are used. However, in some special cases, some hospitals still perform this cryosurgery treatment.
Who needs this treatment?
There are several situations in which a doctor might suggest this treatment for you. Let's see what they are.
- Abnormal cells in the cervix: If your Pap test reveals that your cervical cells are abnormal, or have a high risk of developing into cancer (cervical dysplasia), this procedure may be recommended to remove those cells.
- Cervicitis: Sometimes the cervix can become infected, swollen, and red. This method is used in some cases that do not respond to medication.
- Genital Warts: This treatment can also be used to remove warts that form on the surface of the cervix due to the HPV virus.
- Unexplained cervical bleeding: Sometimes, small amounts of bleeding can occur due to the fine blood vessels on the surface of the cervix. There are times when this treatment is also performed.
What happens before treatment?
This is not a major surgery. You will not need to stay in the hospital. It can be done in the doctor's room (OPD). It is done while you are conscious. There is no need for general anesthesia.
- Numbness: Sometimes the doctor may inject a small amount of local anesthesia into the cervix. But most of the time, that's not necessary because the cervix has very little nerve sensation.
- Calming down: If you are very scared and anxious, you may be given a small amount of medicine to calm you down.
- Personal preparation: Your doctor will tell you to avoid having sex and not insert anything into your vagina for 24 to 48 hours before treatment.
What happens during the treatment? Step by step
The entire process takes less than 10 minutes , so there's no need to worry. It feels just like getting a Pap smear.
1. Position: First, you will be asked to lie down on a bed, usually used for a gynecological examination, with your legs spread out to the sides.
2. Inserting the Speculum: Next, remember the instrument you use when you get a Pap smear? A similar instrument (speculum) is inserted into the vagina and gently pushes the vaginal walls apart so that the cervix can be seen clearly.
3. Cryoprobe: Next, the doctor inserts a long, thin, pencil-like metal instrument (called a cryoprobe) into the vagina. A very cold liquid flows through this instrument, making the tip of the instrument as cold as ice.
4. Freezing the cells: Now the doctor places the tip of the ice-cold instrument exactly where the abnormal cells are on your cervix and holds it there for a few seconds or minutes. This extreme cold (like -20 to -50 degrees Celsius) freezes the cells.
5. Thaw and repeat: Then remove the device and let the area thaw a bit. If necessary, freeze the cells again in the same way. That's it.
Most of the time, this is not painful. You may feel a little discomfort, like a period pain, in your lower abdomen. But you shouldn't feel any pain. Some people may feel a little dizzy after the treatment.
What to expect after treatment?
You can go home as soon as the treatment is over. There is no need to stay in the hospital.
- A watery discharge: After treatment, for a few weeks , you may start to have a watery, sometimes bloody, discharge from your vagina. This is normal and nothing to worry about. This is because the frozen cells are dying, thawing, and being released from your body. You can use sanitary pads for this. Do not use tampons for any reason .
- Pain: If you have a minor stomach ache, you can take a general painkiller like paracetamol.
- Things to avoid: Avoid having sex until your cervix is completely healed, which will take about 2-3 weeks . Also, avoid inserting anything into your vagina (e.g. tampons, douches). This can help prevent infection.
- Follow-up: This is definitely important . The doctor will give you a day to come back. At that time, he will check to see if the abnormal cells have completely disappeared and if the cervix has healed well. At that time, you can have another Pap test or, if necessary, a biopsy.
What are the advantages and disadvantages of this treatment?
Like any medical treatment, this cryosurgery treatment has both advantages and disadvantages. Let's take a closer look at them.
| Advantages | Disadvantages |
|---|---|
| Not a surgery: Since there is no cutting of the body, the risk of pain, bleeding, and complications is very low. | Unable to test cells: Because the cells are destroyed, the removed part cannot be sent to a lab to see if there are cancer cells. |
| Quick and easy: It takes about 10 minutes to complete. No need to stay in the hospital. | Less accurate: Not as accurate as other methods (like LEEP). Sometimes abnormal cells can be missed. |
| Low cost: The cost is relatively low when compared to other surgeries. | Cannot go deep: Only effective on cells on the surface of the cervix. This method will not work if the cells have gone deep into the cervix. |
| No effect on fertility: This treatment generally does not affect the ability to become pregnant in the future. | Not suitable for serious conditions: This method is not suitable for removing cells that are at high risk of turning into cancer (e.g. CIN 3). |
How effective is this treatment?
This treatment is about 90% effective . That means that in 90 out of 100 people treated, the abnormal cells will not come back. However, a very small number of people may develop abnormal cells again. If that happens, they will have to resort to another treatment, such as LEEP.
What time do you need to talk to the doctor?
Although it is normal to experience some discomfort and watery discharge after treatment, certain symptoms may be a sign of infection or other complications. If you have any of the following symptoms, call your doctor immediately. Or go to the nearest hospital emergency department (ETU).
| Warning signs to look out for | |
|---|---|
| 🌡️ Fever | If the body temperature is 100.4 Fahrenheit (38 Celsius) or higher. |
| 🩸 Heavy bleeding | If you bleed more than your normal monthly period. |
| 😖 Severe abdominal pain | An unbearable pain in the lower abdomen that doesn't subside even after taking paracetamol. |
| 👃 A foul-smelling discharge | If the vaginal discharge has a foul odor (this is a sign of an infection). |
In conclusion, cervical cryosurgery is a relatively old procedure, but it is still a simple, safe, and effective treatment that is still used in some cases. If your doctor suggests this treatment, don't be afraid to do it. Keep the information in this article in mind, and talk openly with your doctor if you have any questions. You and your doctor are the ones who make decisions about your health together.
Take-Home Message
- Cryosurgery is a simple treatment that uses extreme cold to destroy abnormal cells in the cervix.
- This is not a major surgery. It takes about 10 minutes. There is no need to stay in the hospital.
- The treatment is not very painful. You may feel a slight cramping, similar to menstrual cramps.
- It is completely normal to have a watery discharge from your vagina for a few weeks after treatment. Don't worry about it.
- Avoid sexual intercourse and using tampons until completely healed (2-3 weeks).
- Be sure to go to the follow-up appointment given by the doctor. It is very important.
- If you have a high fever, heavy bleeding, unbearable pain, or foul-smelling discharge, inform your doctor immediately.
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