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John L. Pfenninger, M.D.
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Cryocautery of the cervix is a fancy term which means that the outer layer of cells of the cervix are frozen using a special flat instrument about the size of a quarter. This freezing is generally done for several reasons: chronic inflammation of the cervix, an abnormal pap smear, or for warts. If you have had an abnormal Pap smear, you will probably have already had colposcopy. Your doctor has determined that the best way to treat the lesions found is to freeze them.
As you may have learned, most cases of cancer of the cervix are highly associated with infection of the human papilloma virus. These are the same viruses that cause warts. Just as one of the treatments for warts on fingers, arms, and other parts of the body is freezing, so too the treatment for the lesions on your cervix, which may be caused by warts, is freezing. As a matter of fact, often times the same instrument is used, just with a different type of freezing tip.
Cryocautery, or freezing of the cervix, takes place in our office. You should plan on twenty minutes of time. You will be asked to lie back in the usual pap and pelvic position. It is best to have this done during the 5 days after your period. We cannot do it 5 days prior to or during your period.
When the doctor turns the instrument on, you will hear a small hissing sound. Then you may feel some cramping as if you were having a menstrual period. The freezing lasts for only three minutes. The cervix is allowed to thaw, then is frozen for a second time. There is no cutting, burning, or bleeding of any sort. Taking four (4) ibuprofen (Advil or Nuprin) two hours prior to the procedure will help prevent the discomfort of the cramps. You generally do not experience pain.
Amazingly, there are only rare complications of cryocautery of the cervix except for the cramping already mentioned. Very rarely it may cause scarring and narrowing of the cervical canal to the degree that it actually blocks the opening (stenosis). This could cause problems in getting pregnant. Cryocautery is probably best avoided, if possible, during pregnancy. Infection could occur, so if your discharge lasts more than three weeks and is not getting better, call the office. You may also note spotting when your resume intercourse or use tampons. You may want to avoid both for 2-3 weeks.
It is very important to note that cryocautery is effective only 85-90% of the time. That means 5-15% of patients will need to be retreated. Sometimes cryocautery (freezing) is used again. Sometimes laser or other treatments will be suggested. This emphasizes why follow-up is so important. After two treatments, the cervix is protected in 99% of cases.
After cryocautery, you can expect a rather profuse vaginal discharge for two to three
weeks. THIS IS
It is recommended that you have a follow-up pap smear in four months, eight months, and 12 months after the freezing. If any of these Pap smears return as abnormal, your physician will give you specific instructions as to what to do next.
It is generally recognized that the wart virus is highly associated with cervical cancer, and they are very contagious. Eighty percent of sexual partners will have HPV on the penis or in the genital areas. Of these, less than half will be visible with the naked eye. To identify the others, special staining is needed followed by an exam with a special microscope. This procedure is called androscopy and occasionally may be recommended for your sexual partner. If your partner has visible warts, they should be treated. If you smoke, you have a much higher chance of developing cervical cancer, and once again, it is strongly discouraged. In the future, no matter what you read in the newspapers or magazines, you are at high risk for developing cervical cancer and should have, at the least, annual Pap smears. Even when treated, you have a 1% chance of developing cervical cancer in your lifetime. A balanced diet, high in fruits and vegetables, is also very important. Taking additional vitamins could also help.
Should you have any questions or concerns, please feel free to discuss these with your physician. These are only general guidelines and may be varied in your case, depending on your particular situation.
Copyright, 2011. John L. Pfenninger, M.D. Jw02/11