The Natural History of Cervical Cryosurgical Healing

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Original Research

The Natural History of Cervical Cryosurgical Healing

J Fam Pract. 2000 August;49(8):694-700

References

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The reduced quality of life that women experience after cryosurgery may potentially influence the cost-effectiveness of the procedure. Many interventions have been tested to decrease the symptoms of the healing process and to improve the tolerability of this post-treatment experience. To decrease the amount of hydrorrhea, some have tried a sugar solution applied to the vagina to alter the vaginal flora, thus promoting faster re-epithelialization and decreasing the hydrorrhea.²⁰ Others have tested the effect of systemic steroids for minimizing the immunologic reaction of inflammatory edema to the cervical tissue after the cryosurgical trauma.²¹ However, the risk of these nonstandard treatments outweighs the possible benefits of reduced hydrorrhea. Although there is scant literature on effective methods for decreasing the malodor of hydrorrhea, the pain and cramping that women experience after cryosurgery can be addressed directly by giving them permission to use NSAIDs or similar agents for the expected discomfort.

This work and its companion paper⁴ have described the symptoms women experience after cryosurgery and have advocated a better preprocedural informed consent process. We have also asked physicians to question their practice of treating women with CIN grade 1 human papillmavirus (CIN 1/HPV) lesions immediately with cryosurgery. Since CIN 1/HPV lesions regress to normal almost 80% of the time, the use of cryosurgery could be held for those recalcitrant lesions that do not regress, thus sparing women the experience of cryosurgery. These studies also provided the necessary data to explore how women experiencing the symptoms of healing after cryosurgery will comply with future cytology screenings. Future work will address this compliance.

Acknowledgments

This study was supported by the Wallach Surgical Devices, Orange, Conn (DGF) and by the Robert Wood Johnson Foundation (DMH).

We wish to thank all who helped with the pad distribution and weighing, especially Melissa Martinez-Fordham, who participated most fully in the process, exhibiting dedication, precision, and pleasant attitude throughout all pad weighing sessions, and Roberta O’Kelly and Rita Pruitt for their consistent clinical help.