Cryocautery or cryosurgery is a procedure that uses very cold temperatures to treat abnormalities of the female genital tract in addition to other areas of the body such as the skin. Very cold temperatures cause tissue destruction just as very hot temperatures will (a burn). The advantage of using the cold temperatures is that there is much less discomfort associated with the procedure (than a hot cautery), and there is not the unpleasant smell associated with a hot cautery. The most common reasons for performing a cryocautery in gynecology are for abnormalities of the cervix as demonstrated on Pap smear (see PAP Smear in Patient Health Information) or colposcopy (see Colposcopy in Procedures), in addition to resistant infections of the cervix, and for severe cervical erosion which may cause cervical bleeding and/or heavy discharge. Cryocautery is also used occasionally for treatment of lesions in the vagina and also on the skin just outside the vagina.

How is cryocautery of the cervix performed? A speculum is inserted as if you were going to have a Pap smear. A special instrument with a metal tip is then placed against the cervix (or vagina) and liquid nitrous oxide is circulated through the metal tip. The circulating nitrous oxide causes extremely cold temperature in the metal tip; this is transferred to the cervix or vagina. The freezing is done for approximately 2 to 5 minutes, and then the cervix or vagina is allowed to thaw for an equal length of time. The freezing is repeated a second time in order to give the best chance of removing the abnormal tissue. If the cryocautery is being performed for a cervical abnormality, you will be advised to have a repeat Pap smear in three to four months to assure that the lesion or abnormality has not returned.

What are the effects and after-effects of the cryocautery? During the procedure itself, most patients say they feel a mild pressure or mild menstrual-like cramping in the lower part of their abdomen. Some patients state they feel absolutely no discomfort at all, and a very rare patient will say that the procedure is quite uncomfortable. Many physicians recommend taking medication such as ibuprofen 30 to 60 minutes before the procedure to reduce the cramping. After the procedure is completed, you may expect a very heavy, watery discharge which at some times may be bloody. This discharge may last up to one month. As long as you are having the discharge, it is important that you drink plenty of liquids so you do not become dehydrated. You will most likely want to wear a mini pad while you are having the discharge. Rarely, a patient will say that she has moderate to severe cramping several days after the procedure. If this is a problem for you, it is suggested that you take ibuprofen or similar medication that you would normally take for menstrual cramps. If this is not adequate to eliminate the discomfort, you should call your physician. Because of the heavy discharge and the affect of the cryocautery on the cervix or vagina, it is advised that you abstain from intercourse for approximately two weeks.