Cryosurgery of Cervix

Cryosurgery of Cervix

Article
Women's Health
Surgical Procedures
Contributed byMaulik P. Purohit MD MPHMay 07, 2018

Background Information:

What are the other Names for the Procedure?

  • Cervix Cryosurgery
  • Cervix Surgery
  • Cryosurgery of Uterine Cervix

What is Cryosurgery of Cervix surgical procedure?

  • Cryosurgery of Cervix is a procedure that uses a Cryosurgery probe to remove damaged or infected tissue, from within the cervix
  • A Cryosurgery probe is a medical instrument that uses freezing cold, compressed liquid nitrogen, to freeze abnormal, infected, or diseased tissue

What part of the Body does the Procedure involve?

A Cryosurgery of Cervix procedure involves the cervix and vagina.

Why is the Cryosurgery of Cervix surgical procedure Performed?

The Cryosurgery of Cervix is a procedure that is used to treat cervicitis (infection of the cervix) and cervical dysplasia (pre-cancerous condition that may lead to cancer, if left untreated).

What are some Alternative Choices for the Procedure?

Some alternative choices include:

  • Cauterization: It is a procedure used to destroy abnormal (noncancerous or precancerous) cells on the cervix
  • It can also be carried out through the use of heat, electricity, corrosive chemicals, laser, or surgical excision

What are the Recent Advances in the Procedure?

Use of alternative surgical techniques instead of Cryosurgery, has been some of the advances in the procedure.

What is the Cost of performing the Cryosurgery of Cervix surgical procedure?

The cost of Cryosurgery of Cervix procedure depends on a variety of factors, such as the type of your health insurance, annual deductibles, co-pay requirements, out-of-network and in-network of your healthcare providers and healthcare facilities.

In many cases, an estimate may be provided before the procedure. The final amount depends upon the findings during the surgery/procedure and post-operative care that is necessary.

When do you need a Second Opinion, prior to the Procedure?

  • It is normal for a patient to feel uncomfortable and confused by the information regarding Cryosurgery of Cervix and on what needs to be done
  • If the patient needs further reassurance or a second opinion, a physician will almost always assist and also recommend another physician, if required
  • They can also choose to approach another physician independently. Besides, if the procedure has many alternatives, the patient may take a second opinion to understand and choose the best one

What are some Helpful Resources?

http://www.nlm.nih.gov/medlineplus/ency/article/002917.htm

http://my.clevelandclinic.org/services/cryosurgery/hic_cryosurgery_of_the_cervix.aspx

http://www.thirdage.com/hc/p/14788/cervical-cryosurgery-what-to-expect

http://www.hopkinsmedicine.org/kimmel_cancer_center/centers/cervical_dysplasia/about_cervical_dysplasia.html

Complete Guide to Symptoms, Illness & Surgery; Written by H Winter Griffith, M.D.; Revised and updated by Stephen Moore, M.D. and Kenneth Yoder, M.D.; The Berkley Publishing Group, 5th Edition, New York, 2006

Prior to Cryosurgery of Cervix surgical procedure:

How is the Cryosurgery of Cervix surgical procedure Performed?

  • The individual is placed in a lithotomy position. The patient lies flat on the back (supine), with feet raised and supported by foot rests, called stirrups
  • An instrument called a speculum, is inserted into the vagina
  • The speculum gently spreads the vaginal walls, following which the inside of the vagina and the cervix can be seen
  • A Cryosurgery probe is then placed on the area of concern for few minutes, and the abnormal tissue destroyed
  • Sometimes, local anesthesia is injected to numb the cervix, prior to the procedure

Where is the Procedure Performed?

A Cryosurgery of Cervix is usually performed in an out-patient surgery center facility or a physician’s clinic/office. Normally, the individual can go home once the procedure is completed.

Who Performs the Procedure?

A Cryosurgery of Cervix is performed by an obstetrician, a gynecologist, a family physician, or a trained general surgeon.

How long will the Procedure take?

A Cryosurgery of Cervix procedure usually takes about 10-20 minutes.

What do you need to tell your Physician before the Procedure?

It is very important to provide the following information to your healthcare provider. This enables your healthcare provider in assessing the risks for the surgical procedure and helps avoid unnecessary complications.

  • Provide a complete list of medications you are currently, taking to your physician. This information is useful for a variety of reasons. For example, it can help your healthcare provider prevent complications due to a drug interaction
  • If you are allergic to any specific medication or food items
  • If you are taking blood thinners, such as aspirin, warfarin, herbal supplements, or any other such medications
  • If you or your family members, have a history of bleeding disorders, or if there is a tendency to bleed more than normal
  • If you have diabetes, high blood pressure, chest pains, or have previously suffered from a heart attack
  • If you have ever been diagnosed with blood clots in your leg (deep vein thrombosis) or lung (embolism of lung)
  • If you have a history of frequent bone fractures (this may affect bone-healing, if bones are involved as part of your procedure)
  • A list of all previous surgical procedures you have undergone, like for example: Removal of appendix, gallbladder, or any other part, of your body; surgical repair of any body part, such as hernia repair, perforation of bowel wall, etc.

What Preparations are needed, prior to the Procedure?

  • The physician may evaluate the individual’s medical history to gain a comprehensive knowledge of the overall health status of the patient including information related to the medications that are being currently taken
  • Some medications increase a person’s chances of bleeding and it may be recommended to discontinue them for a period of time, before the procedure is performed
  • Blood tests may be performed to determine if there is a bleeding tendency or any other medical conditions that prevents the person from undergoing the procedure
  • Inform the physician if you are allergic to any local anesthetics, lidocaine, etc.
  • Avoid application of any deodorant, or topical medicines on the area, prior to the procedure
  • It is advisable to quit smoking and the use of any nicotine based products, for a while, before the surgery
  • Consumption of alcoholic drinks must also be avoided for a period of time, as instructed
  • For persons suffering from diabetes, it is important that the blood sugar stays within the normal range; if not their diabetologist may have to control blood sugar by recommending insulin and/or a combination of oral medicines
  • A physician will request your consent for the Cryosurgery of Cervix procedure using an Informed Consent Form.

What is the Consent Process before the Procedure?

A physician will request your consent for the Cryosurgery of Cervix procedure using an Informed Consent Form.

Consent for the Procedure: A “consent” is your approval to undergo a procedure. A consent form is signed after the risks and benefits of the procedure, and alternative treatment options, are discussed. This process is called informed consent.

You must sign the forms only after you are totally satisfied by the answers to your questions. In case of minors and individuals unable to personally give their consent, the individual’s legal guardian or next of kin, shall give their consent for the procedure.

What Tests are needed, before the Cryosurgery of Cervix surgical procedure?

Before a Cryosurgery of Cervix procedure, the patient has to undergo certain tests such as:

  • Vaginal examination
  • Pap smear

The physician may suggest further tests depending on the health of the patient and their medical history.

What are some Questions for your Physician?

Some of the basic questions that you might ask your physician are as follows:

  • What is a Cryosurgery of Cervix?
  • Why is this procedure necessary?  How will it help?
  • How soon should I get it done? Is it an emergency?
  • Who are the medical personnel involved in this procedure?
  • Where is the procedure performed? 
  • What are the risks while performing the procedure?
  • What are the complications that might take place, during recovery?
  • How long will it take to recover? When can I resume normal work?
  • What are the alternatives to the procedure?
  • How many such procedures have you (the physician) performed?
  • Are there any follow-up tests, periodic visits to the healthcare facility required, after the procedure?
  • What are the costs involved?

During the Cryosurgery of Cervix surgical procedure:

What kind of Anesthesia is given, during the Procedure?

Generally, no anesthesia is administered for this procedure. However some physicians may administer local anesthesia to the cervix.

How much Blood will you lose, during the Procedure?

Since Cryosurgery of Cervix is a less invasive procedure, there is little or no blood loss involved.

What are the possible Risks and Complications during Cryosurgery of Cervix surgical procedure?

There are usually no surgical risks or complications associated with Cryosurgery of Cervix. However, there are general factors that increase the risk of getting complications during the procedure, which include:

  • Obesity: Generally greater the degree of obesity, greater is the surgical risk
  • Smoking: Longer the smoking history (in pack years smoked), greater the surgical risk
  • Advancing age
  • Poorly controlled diabetes, as evidenced by a high hemoglobin A1c and a high fasting glucose
  • Poorly functioning kidney, as evidenced by increased BUN (blood urea nitrogen) and blood creatinine
  • Poorly functioning liver, as evidenced by increased blood liver function tests
  • Hypertension (increased blood pressure), especially if it is poorly controlled
  • Poor nutritional status (malnutrition with mineral and vitamin deficiencies)
  • Poor lung function, as evidenced by abnormal lung function tests
  • History of bleeding disorders
  • Longstanding illness, such as autoimmune disorders, chronic infections
  • Poor immune system due to a variety of causes

What Post-Operative Care is needed at the Healthcare Facility after Cryosurgery of Cervix surgical procedure?

At the healthcare facility, usually there is no requirement for any post-procedure care, unless any complications arise. 

After the Cryosurgery of Cervix surgical procedure:

What are the possible Risks and Complications after the Cryosurgery of Cervix surgical procedure?

Post Cryosurgery of Cervix, the following complications may arise:

  • In rare cases, infection of the surgical wound may occur
  • Narrowing of the spinal canal (cervical stenosis)
  • Sometimes, using the procedure, it is not possible to completely remove all abnormal tissue

What is the Prognosis after the Surgery?

  • Prognosis is usually good with a complete recovery expected, within 3 weeks
  • However, a foul odor associated with vaginal discharge may occur and last for a period of 7-10 days

When do you need to call your Physician?

Do contact your physician if you notice any of the following symptoms:

  • Foul odor of vaginal discharge
  • Increase in pain
  • Abnormal vaginal bleeding or swelling

What Post-Operative Care is needed at Home after the Cryosurgery of Cervix surgical procedure?

At home, the following post-operative care is recommended, after a Cryosurgery of Cervix procedure:

  • Keep the wound clean and dry
  • Wear cotton underwear
  • It may be required to use sanitary napkins (for bleeding) for about a week or more
  • Avoid douching, unless advised by your physician
  • Avoid tampons, which may cause an infection, unless your physician recommends them
  • Avoid taking nonprescription medications, such as aspirin. However, the individual may take acetaminophen to relieve pain, if necessary

How long does it normally take to fully recover, from the Procedure?

Complete recovery from this procedure usually takes about 3 weeks.

Additional Information:

What happens to tissue (if any), taken out during the Procedure?

The procedure does not involve the surgical removal of any tissue.

When should you expect results from the pathologist regarding tissue taken out, during the Procedure?

Since no tissue is removed during the procedure, a pathologist does not get involved in the care of the patient.

Who will you receive a Bill from, after the Cryosurgery of Cervix surgical procedure?

It is important to note that the number of bills that the patient may receive depends on the arrangement the healthcare facility has with the physician and other healthcare providers.

Sometimes, the patient may get a single bill that includes the healthcare facility and the consultant physician charges. Sometimes, the patient might get multiple bills depending on the healthcare provider involved. For instance, the patient may get a bill from:

  • The outpatient facility or a physician’s office
  • An anesthesiologist (if anesthesia was administered)
  • An obstetrician, a gynecologist, a family physician or a general surgeon

The patient is advised to inquire and confirm the type of billing, before the Cryosurgery of Cervix procedure is performed.

Thanks and Gratitude:

We sincerely acknowledge and thank Dr. Douglas J. Jones for reviewing the article. His valuable input and feedback has helped enrich the contents of this article.

Douglas J. Jones, MD FACS
Board Certified General Surgeon and Faculty Member
University of Illinois, College of Medicine at Urbana-Champaign
506 S. Mathews Ave., Urbana, IL 61801, USA

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Maulik P. Purohit MD MPH picture
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Maulik P. Purohit MD MPH

Assistant Medical Director, Medical Editorial Board, DoveMed Team

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