Cervical Cryocautery

Published on 30/05/2015 by admin

Filed under Obstetrics & Gynecology

Last modified 30/05/2015

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Chapter 239 Cervical Cryocautery

DESCRIPTION

Cervical cryocautery is the use of cold to produce “frost bite” as an ablative therapy for cervical abnormalities.

INDICATIONS

Histologically verified advanced epithelial atypia. Because this is an ablative technology, a histology must be established prior to instituting this therapy.

CONTRAINDICATIONS

Undiagnosed cervical lesions, pregnancy.

REQUIRED EQUIPMENT

• Skin (or vaginal) preparation materials (iodine-based antibacterial solution [e.g., Betadine] or other suitable cleansing agents)
• Cryosurgery unit (e.g., nitrous oxide-powered, carbon dioxide or similar)
• Cryoprobes: flat and conical, assorted sizes
• Water-soluble lubricant (e.g. K-Y Jelly)
• Timer (optional, although recommended)
• Vaginal speculum
• Colposcope (if colposcopy has not been previously performed or the boundaries of the lesion are not visible)
• 3% to 5% acetic acid (white vinegar) or Lugol (5%) solution (if desired)
• Gauze pads and/or cotton balls
• Vaginal sidewall retractor (optional)
• Ibuprofen (800 mg) or other similar nonsteroidal anti-inflammatory agent taken approximately 1 hour prior to therapy (if desired)

TECHNIQUE

After informed consent has been obtained, the patient is placed in the dorsal lithotomy position as for a speculum examination. The cervix should be brought into view and any cultures or cytologic smears should be obtained as needed. If the extent of the lesion has not been documented or is not immediately visible, acetic acid or Lugol solution should be applied to the cervix to delineate the area of abnormality.

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