Cryosurgery of the cervix is ​​a painless and effective treatment. Cryodestruction is a modern method of treating diseases of the cervix Pulls the stomach after cryodestruction of the cervix

Modern gynecology has a whole arsenal of means to combat benign pathologies of the cervix, such as erosion or retention cyst. Cryodestruction (nitrogen cauterization) is one of the most sparing methods of treatment, it gives a good result and, moreover, has minimal consequences for the female body.

What is the procedure

The word "cryolysis" in direct translation from Latin means the process of destruction of something by cold. The essence of the procedure is the direct impact on the affected segment of the cervix of the sub-zero temperature, which results in the death and rejection of the cells of the formation, followed by the replacement of the area with healthy tissues.

For exposure to cold, liquid nitrogen is used, which, evaporating, is able to freeze cells to temperatures below 100 0 C, or rather, from -90 0 C to -140 0 C.

With the help of an apparatus called a cryodestructor, cauterization is carried out

Do not be afraid that the substance will cause damage to healthy tissues - it is applied pointwise to the desired segment using a special cryoprobe.

Advantages and disadvantages of cauterization with liquid nitrogen

Benefits include the following factors:

  • the speed of the procedure - no more than 5-10 minutes;
  • outpatient cryodestruction, i.e. immediately after it, the patient can go home;
  • no bleeding;
  • sparing nature of the procedure, leaving no scars;
  • acceptable price;
  • low risk of complications.

Moreover, cryodestruction has certain disadvantages:

  • compared to other methods of treatment (laser or radiological removal of the formation and electrocoagulation), cryodestruction demonstrates a lower rate of healing of the postoperative wound;
  • in varying degrees, the patient may have pain;
  • the gynecologist is not able to control the degree of depth of impact on the affected segment, as a result of which additional sessions may be needed;
  • if the areas of damage are localized at different depths, damage to healthy tissues is possible, which can lead to scarring;
  • copious exudative discharge for some time after the procedure;
  • a ban on the use of vaginal tampons until the wound is completely healed;
  • sexual abstinence for 1–1.5 months.

Benefits of cryotherapy - video

In what cases is it prescribed to carry out cryodestruction of the cervix, to whom it is contraindicated

  • cervical erosion;
  • ectopic columnar epithelium;
  • leukoplakia of the cervix;
  • retention cysts of the cervix;
  • papillomas of the vulva, vagina;
  • warts of the vulva, vagina, perineum;
  • ectropion.

Contraindications to the procedure:

  • pregnancy;
  • period;
  • acute inflammatory diseases, including the organs of the genitourinary sphere;
  • urinary infections;
  • fibroids and endometriosis of the uterus;
  • tumor lesion of the ovaries;
  • pathologies and damage to the vagina and cervix - cicatricial deformities, dysplasia;
  • the area of ​​the lesion is more than 3 cm (with deep and extensive foci, the patient is recommended to use other methods of treatment).

How is the procedure: preparation for cauterization

First, the patient undergoes a traditional examination by a gynecologist, and then a colposcopy to clarify the nature of the lesion. Also, the doctor must take swabs for microflora and infections (PCR), and, if necessary, a tissue sample for histology. In many cases, the selection of material for biopsy is carried out directly during the procedure.

Cryodestruction is performed on the 7-10th day of the menstrual cycle.

No special preparation before the procedure is required. It's a good idea to shave your bikini area and bring a discharge pad with you.

Manipulation progress

With the help of a special cryoprobe, the gynecologist acts on the affected area for several minutes, after which the patient can go home. At the time of cryodestruction, a woman may feel slight discomfort, namely, weak aching pains in the lower abdomen, as is sometimes the case with menstruation, as well as a feeling of heat in the form of hot flashes.

During cryodestruction, blood is not released, since small vessels in the area of ​​​​operation spasm from the cold, which causes their blockage - thrombosis.

Postoperative period

After half an hour or an hour, edema occurs in the area of ​​cryodestruction, which soon resolves spontaneously. At the site of exposure to low temperature, bubbles filled with liquid form. They gradually dry up. Finally necrotic tissue is torn off in a month or two after the procedure, leaving behind a barely noticeable speck.

Colorless exudative discharge in a patient usually lasts up to a month. In some cases, they may have an odor, but this fact must be told to the attending physician.

Within a month after treatment, you should not go to the beach and swim in the pool

Possible consequences

In most cases, qualified cryodestruction does not lead to scarring, which can disrupt the elasticity of the cervix and vagina, so the procedure is recommended for nulliparous women. In addition, during the manipulation, healthy tissues do not suffer, fully maintaining their functionality.

In rare cases, when cryodestruction is performed without taking into account the nature of the lesion (its size and depth), scar tissue may form in the segment of the cervical canal, which can lead to subsequent complications during childbirth.

Reviews of women who have undergone treatment

... Gynecologists recorded erosion, but ordered to wait until the birth. Well, that time has just come - after the second birth, the doctor suggested me cryodestruction. Moreover, I knew that our polyclinic had more modern equipment - a radioknife, but the doctor chose cryodestruction, and it was useless to argue, of course. Before the procedure, it was recommended to shave, and after the procedure - not to live sexually for a month. Not an easy, of course, restriction for those who are married). But what to do ... The procedure itself was no more unpleasant than ordinary gynecological examinations. I even thought that such an easy (for the patient) procedure would hardly help me completely get rid of the problem ... But a miracle - during the subsequent examination, the doctor noted that everything went fine. And now at every physical examination (I go through every year), doctors, now different, say that the cervix is ​​​​completely clean. So I'm very happy that I was lucky and everything ended so well.

good spring

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Cauterization is done on a regular gynecological chair. Conducted by a doctor and a nurse. The nurse supported me. The doctor went above and beyond. Thank them very much. At the end of the operation, he goes into a fever, then into a cold, then again into a fever. I immediately had a headache and my stomach began to hurt like during menstruation. You can’t immediately get up, you need to lie still for at least 5 minutes, because there may be dizziness and even loss of consciousness. I didn’t have that, I didn’t even have a slight dizziness! I jumped out of my chair and went quietly home, and, by the way, when I went out into the fresh air, I instantly felt better, the fever went away, my head stopped hurting. My stomach hurt a lot for the first 2 days. Saved by painkillers. The funniest thing was waiting for me ahead ... IT'S copious lymph flow. Oh, how I suffered with them ... I warn you right away, girls who are just preparing for this procedure, stock up on pads !! I did not have time to change them, especially the first 5 days. They were filled like diapers.))) After a week, the discharge becomes smaller, and after 2 weeks it practically disappears. During this period I spent a lot of pads, probably for a year with monthly ones, I didn’t spend so much. Well, nothing, it's for the sake of health! The discharge is clear, slightly yellowish, odorless. This is normal. It is bad when the discharge is bloody or smelly.

Lenchik82

http://otzovik.com/review_660883.html

There were absolutely no sensations, I don’t even remember the red face, if there was a slight rosy cheek, then just a drop. And then I went out and went, as usual, as after a regular test. I went, as if nothing had happened, in the subway, in a minibus, I got home. There were no discharges or sensations. It seems that they were forbidden to live sexually for several weeks, until everything lives there. One month later, colposcopy showed a smooth neck, with no signs of erosion. So this is a very effective and necessary method of treating cervical erosion.

koala2014

http://otzovik.com/review_1384688.html

The cryodestruction procedure itself (or, more simply, cryo) - treatment of the cervix with liquid nitrogen - was done to me many years ago in 2006. It was the only one at that time (at least the gynecologist told me that this manipulation was performed) a cauterization procedure that could be done to nulliparous women. Its advantages were as follows: - the procedure itself is practically painless, only a feeling of chill and pulls the lower abdomen a little (after undergoing cauterization with the help of a radio wave, it seems that cryo is more humane in relation to the female body); - after that there was drug therapy that could be done myself without the help of medical staff - home-made tampons with medicine (to order, I don’t remember the name) and injections in the leg; - after 6 years, it was the cryodestruction that did not in any way affect pregnancy and childbirth, - the result (the condition of the cervix) pleased a lot years of gynecologists, and not just one, both before childbirth and after. It’s like living and rejoicing, but this year (2015) I had to undergo a second procedure for treating cervical erosion, but without the help of cryodestruction, since this method is considered outdated. The reasons are not clear, it seems that at that time the most effective remedy was considered, and practice has shown that such a sparing method turned out to be short-lived. Therefore, from the point of view of painless sensations, it could be recommended, but from a temporary point of view - no.

I have a medical degree with over 20 years of experience. She worked in the laboratory service, after that for a number of years she held the position of a transfusiologist in one of the blood transfusion institutions.

Increasingly today, gynecologists have begun to use non-invasive methods of treatment for women's diseases, and cryodestruction of the cervix without surgery is one of them.

Cryodestruction of the cervix is ​​an accurate, bloodless and gentle method, it is preferable for women planning to have children in the future. Before the appointment of the procedure, the vaginal cavity is carefully examined.

Cryodestruction is not performed when:

  • infection of the genital organs;
  • severe inflammation of the vagina;
  • uterine fibroids requiring removal by other surgical means;
  • advanced endometriosis.

Affected uterine tissues are exposed to cold, low temperatures. When carrying out cryodestruction of the uterus, a special device is used - a cryodestructor with liquefied gas, carbon dioxide liquid nitrogen or nitrous oxide inside the cooled tissue to almost 200 gr. Under the influence of low temperatures, the affected cells freeze, and the neoplasms are destroyed. The depth of freezing of the uterine zone depends on the gas used. The introduction of liquid nitrogen for just a couple of minutes leads to freezing of the zone up to 5 mm deep, but still, nitrogen cannot remove large erosive zones.

Often, cryodestruction requires a second examination of the uterine cavity based on analyzes, as well as bleeding from the cervix, after the procedure for the first time. The method is good because it does not lead to the destruction of nearby healthy tissues, and blood clots form in the affected areas of the vessels, blood does not flow, the tissues simply begin to die, necrotic, and after a few months they are completely released from the uterus.

What is the cryodestruction method good for?

Previously, erosive areas were cauterized and many women know about the consequences. The remaining areas of the lesion after a while began to progress again. Freezing the erosive zone:

  • does not lead to bleeding due to a violation of blood microcirculation under the influence of cold;
  • Patients do not experience discomfort during the procedure. Low temperatures affect the nerve endings, freezing them like ice-caine, but are fully restored as the wounds heal;
  • infection of the affected areas with erosion is excluded. The immune system at low temperatures enhances its functions;
  • reproductive function remains intact;
  • the tissues of the uterus, even after freezing, remain elastic, their scarring does not occur;
  • easily tolerated by patients;
  • does not lead to the development of possibly remaining metastases;
  • the procedure is not traumatic, painless;
  • tissues are completely restored;
  • relapses are excluded in the future;
  • there is no need to prepare for this operation;
  • no suturing, painful and uncomfortable for women;
  • after rejection of neoplasms, the tissue is quickly replaced by a healthy one;
  • further complications are excluded.

The cryodestruction procedure has no disadvantages, if you do not take into account the time for wound healing, up to 3 weeks, although the method is not advisable in the presence of neoplasms, extensive large sizes, located in hard-to-reach places.

Freezing the affected area of ​​the uterus with liquid nitrogen has become popular, since cauterization with current, which was used to treat erosion back in Soviet times, has many disadvantages. The cauterization procedure is painful, unpleasant. Wounds heal and regenerate for a long time, constantly bleed, and the most unpleasant thing is that scars remain, tissues become less elastic, infection and bacterial agents can be introduced into the wounds.

Indications for the use of the method

Cryodestruction is applicable for women suffering from:

  • chronic cervicitis;
  • and erosion of the cervix;
  • dysplasia of 1 and 2 degrees;
  • warts in the vulva, perineum, or vagina;
  • leukoplakia of the vulva;
  • capable of recurring after their removal by surgery;
  • ectopic epithelium.

Freezing the affected areas leads to their destruction and death. Also, this method removes papillomas, condylomas from the cervix.

For whom is the procedure contraindicated?

The procedure is unacceptable if women are identified as a result of examinations:

  • tumors in the ovary;
  • 3rd degree;
  • cancer or an intermediate diagnosis;
  • inflammatory processes taking place in the genitals;
  • , severe deformation of the uterus;
  • somatic diseases;
  • acute infectious diseases.

Questions about the possible application of the cryodestruction method are decided by the gynecologist based on the results and examinations.

How is the cryodestruction method performed?

  • take a blood test;
  • a smear for the study of the uterine flora and the absence of sexual infections;
  • a smear on atypical cells to exclude the presence of malignant recurrent formations;
  • biopsy;
  • histological analysis;
  • examination by a gynecologist with a mirror of the cervix.

Only on the basis of the results obtained, the doctor will decide whether it is possible and advisable to carry out this procedure, or whether it is worth choosing a different treatment for erosion.

The swab is wetted with saline. The solution is injected into the cervix for cleansing.
The neck is treated with acetic acid (weak solution) to determine focal areas. There may be a short-term pain, a feeling of discomfort. The uterine cavity is once again treated with saline.
The tip of the crizond is inserted towards the affected area, without touching the walls of the vagina, only at the site of the focus. The device is turned on by the doctor, a timer is set, the surface of the cervix is ​​covered with ice in a matter of seconds.

Freezing for the greatest effect is carried out twice. The cavity is frozen for 3 minutes, then left to thaw for 4–5 minutes, then frozen again. The cryoprobe is separated from the uterus at the time of its thawing. In order to avoid tearing off parts of the cervical tissue, the chrysond is separated while the cavity is partially frozen. To separate the crisond from the wall of the uterus, the doctor will slightly turn it. Frozen white, but already dead tissue will remain at the erosive site. The doctor will examine the cervix and, making sure that there is no bleeding, will lubricate it with Monsel's paste.

Again, a woman should come to the doctor in 2-3 weeks to assess healing and six months later - for a cytological examination of the uterine cavity. It is possible to take a smear, conduct diagnostics-colposcopy.

Consequences of cryodestruction

The method is carried out quickly, up to 3 minutes and there is no need for hospitalization of women. Damaged areas are frozen with liquid nitrogen, and this does not cause trouble for patients. Some women, after the procedure, throws into a fever, but this is normal, the body restores thermal balance. If you get up suddenly, you may feel dizzy, but this feeling also quickly passes.

Tolerability of the method, according to patients, is generally not bad. Pain in the abdomen is possible within 2-3 days due to the release of dead tissues to the outside. Also, the stain on the frozen place will remain dark until complete regeneration. Full recovery can be said no earlier than 3 months after cryodestruction. Scarring of tissues does not occur, but still a woman should be observed by a doctor for some time until the affected areas are completely healed and restored.

Women in the rehabilitation period of up to 2 months need to take care, exclude douching, physical activity, visiting saunas, baths, intimacy. However, when a doctor prescribes this procedure, you should not refuse it. In most cases, similar symptoms, as with erosion, do not bother a woman in the future. The well-being noticeably improves, soon the patients simply forget about their torment and continue to live on with a full, in particular, intimate life.

In what cases should you immediately consult a doctor after cryodestruction?

The method is distinguished by the fact that it does not lead to complications in most cases, but if for some reason or negligence of the doctor, the procedure is carried out in non-sterile conditions in the patient:

  1. The temperature has risen above 38 degrees, shivering.
  2. Severe pain in the lower abdomen.
  3. Purulent fetid discharge is separated from the vagina.
  4. Bleeding does not go away for more than 2 days and is separated by clots, you need to see a doctor as soon as possible.

WHO SAID THAT INFERTILITY IS HARD TO CURE?

  • Have you been wanting to have a baby for a long time?
  • I've tried many ways but nothing helps...
  • Diagnosed with thin endometrium...
  • In addition, the recommended medicines for some reason are not effective in your case ...
  • And now you are ready to take advantage of any opportunity that will give you a long-awaited baby!

Pathological diseases of the cervix in women are often diagnosed. Considering that each of them should become a mother in the future, it is important to choose such methods of therapy that will be less traumatic. Modern medicine has a large number of ways to treat various diseases, and among them cryodestruction of the cervix occupies not the last place. Often the method is used for erosion therapy. This pathology affects more than 60% of female representatives. Moreover, it should be noted that most of this number are women of reproductive age. How is this procedure different from the rest, and what advantages does it have?

Collapse

What is cryosurgery?

This is one of the therapeutic procedures, which involves the use of low temperature to influence the pathological areas. In this method, liquid nitrogen acts as such.

After exposure, freezing of diseased areas is observed, followed by destruction. This method is used in many branches of medicine, including gynecology.

For carrying out, there is a special apparatus - a cryodestructor, which has a tip through which nitrogen is supplied. After the procedure, blood circulation is disturbed, blood clots appear, and tissue necrosis is observed, which gradually leave the body.

The use of liquid nitrogen is possible if the neoplasm has a diameter of not more than 5 mm.

The advantages of this treatment method include:

  • There is no bleeding after the intervention.
  • The woman does not experience pain, as nitrogen freezes tissues like Lidocaine.
  • Infectious complications are excluded.
  • The procedure does not adversely affect the reproductive system of women.
  • No scarring occurs.
  • Full recovery of tissues is observed.
  • Relapses are quite rare.
  • The operation does not require preparation.
  • Dead tissues are quickly replaced by healthy ones.

Cryotherapy has practically no negative sides, therefore, it is increasingly replacing cauterization with current.

Indications for the procedure

Cryotherapy of the cervix is ​​indicated for women with the following pathologies:

The method is popular for the treatment of these pathological conditions, as it is distinguished by its low trauma.

Contraindications

You will have to abandon the procedure using liquid nitrogen if:

  • Neoplasms were found in the ovaries.
  • Diagnosis - dysplasia of the 3rd degree.
  • Oncology or suspicion of it.
  • There is a severe deformity of the cervix.
  • The presence of a large number of scars after previous treatments.
  • Somatic pathologies.
  • Myoma of the uterus.
  • Has endometriosis.
  • At the time of the procedure, infectious diseases were detected.

After the examination of the woman, the gynecologist decides on the advisability and necessity of cryodestruction.

Training

Special preparation for the procedure is not required. The method is usually applied 7-10 days after the onset of menstruation. Before referral, a woman is sent for the necessary examinations:

  • General analysis of blood and urine.
  • Analysis of a smear from the vagina for the presence of infectious pathologies.
  • A smear for the detection of cancer cells.
  • Biopsy.
  • Histological examination.
  • Examination on a gynecological chair.

After the results obtained, the need for such therapy is decided and a date is set. The doctor warns the woman that before the procedure, a couple of days before the procedure, it is necessary to give up intimacy.

Cryodestruction technique

Cryodestruction does not require hospitalization and is performed in the gynecologist's office. Before performing, the doctor must explain to the woman how the procedure is performed, what to expect after it. For a couple of hours, you need to take an anti-inflammatory drug. The technology of cryodestruction is as follows:


The whole procedure takes a few minutes and does not cause pain in a woman. After completing it, she can go home.

Recovery

The first visit to the doctor after the procedure should take place in three weeks. The doctor will assess the degree of therapeutic effect and the speed of recovery. Immediately after the procedure, you can feel:

  • General weakness.
  • Fatigue.
  • Headache.
  • Dizziness.
  • Feels hot.
  • Pain in the lower abdomen.

Allocations after cryodestruction of the cervix are quite normal, since the dead areas should come out. But it is important to know that in excessive amounts it will already be a symptom of pathology.

For most women, the recovery period goes smoothly and without complications, so it does not require medication. But the doctor can prescribe anti-inflammatory drugs for insurance, it is recommended to start taking them on the 3rd day after the procedure.

In the early days, if you are worried about pain, you can take an anesthetic.

Full recovery takes about 2-3 months.

  • Do not visit saunas and baths.
  • Do not use douche.
  • Within a month, exclude intimate relationships.
  • Don't lift weights.

The advice is the same as for any gynecological examination or treatment, but it will speed up the healing process.

Consequences and possible complications

Despite the painlessness, cryodestruction cannot completely replace other methods of treating female pathologies. This can be explained by the negative consequences of the procedure:

  • Great recovery period. Full restoration of tissues occurs in 3 months, while laser treatment or radio wave does not require so much time.
  • The doctor cannot fully control his actions, which can lead to incomplete removal of pathological tissues.
  • Rarely, but in some cases, especially if a large area is treated, scars may appear.
  • Although the method is considered bloodless, sometimes bleeding can occur.
  • Most often, cryotrauma of the vaginal walls can be noted as a complication.
  • If the procedure technique and recommendations are not followed during the recovery period, there is a risk of developing inflammatory pathologies.

If a few days after cryodestruction, a woman notes that the discharge has become more abundant, an unpleasant odor has appeared and their color has changed, pain has risen, the temperature has risen, then you will have to visit a doctor to rule out serious complications.

The method is usually well tolerated, but non-compliance with sterility or the inexperience of the doctor can end in failure.

Is pregnancy possible after cryosurgery?

One of the advantages of this method of treating gynecological problems in women is its absolute safety for reproductive function. The procedure does not affect conception, the period of bearing a baby, as well as the process of labor.

This can be argued if the cryogenic freezing of pathological tissues was carried out in compliance with all the rules and did not end in serious complications.

Expectant mothers can be given advice: before planning a pregnancy, visit a gynecologist and undergo a second colposcopy. With good results, you can safely plan a baby.

Cost of the procedure

Prices for the procedure vary quite a lot in different clinics and range from 2 to 15 thousand. The table shows the cost of the procedure in some clinics.

For the procedure, it is important to pay attention not only to the status and prestige of the center, but also to the qualifications of the doctor. The result will depend on his skill and experience in carrying out such manipulations.

Cryodestruction allows for the minimum time period to remove areas with pathological tissues. The method is characterized by relative safety, painlessness and good efficiency in the treatment of many women's diseases. The most important thing is that the pathology is detected in a timely manner, then the effectiveness of therapy will be maximum.

Instruction

Cervical erosion is a common pathology that can be successfully treated today. One of the safest and most effective methods of erosion treatment is hardware cryodestruction. The procedure is performed on an outpatient basis and does not require hospitalization, is practically not accompanied by painful sensations and rarely causes complications.

For cryodestruction, liquid nitrogen is used, which cools the affected tissues to -190°C or more. Despite the ultra-low temperatures, the procedure is the least traumatic among the various methods of treating cervical erosion. After cryodestruction, there are no scars and no bleeding, as the vessels narrow under the influence of cold. After healing, the tissues retain their elasticity, which means that the procedure does not interfere with natural childbirth in the future and does not complicate the course of pregnancy. Cryosurgery can be safely used to treat nulliparous women. Cryotherapy does not require anesthesia: cooling the tissues reduces sensitivity, so the woman does not experience any pain during the procedure.

Before the procedure, it is necessary to visit a gynecologist who will examine the patient's history, make sure that there are no contraindications to cryotherapy and take all the necessary tests. There is no need to prepare for hospitalization - cryodestruction is performed on an outpatient basis, the procedure itself takes no more than 5-10 minutes, after which the woman can return to her usual mode of life.

Cryotherapy is carried out using a special instrument that is attached to a cylinder of liquid nitrogen. A cryopapilla is inserted into the vagina, which is then pressed against the area of ​​the cervix affected by erosion. The doctor begins the supply of liquid nitrogen, and the affected tissues gradually become white. Usually, the nitrogen supply lasts 3-5 minutes - this time is enough to treat the affected tissues.

The cryopapilla is removed from the vagina 4-5 minutes after the end of the nitrogen supply in order to avoid trauma to the cervix. If the erosion was extensive, a second procedure may be necessary, the need for which the gynecologist concludes.

During the procedure, the woman does not experience pain, because under the influence of cold, the tissues lose their sensitivity. However, the patient may experience tingling and a slight burning sensation in the vagina. After the procedure, a woman needs to prepare for heavy discharge, which will last up to three weeks.

In order to avoid complications after cryotherapy for 1-2 months, it is recommended to refrain from sexual intercourse. Also, you should not take a hot bath, visit the pool, sauna, bath, swim in the river or the sea. The final healing of the cervix after the discharge of dead tissue occurs after 2-3 months.

- local low-temperature effect on pathological foci in the cervical region, as a result of which the altered tissues are destroyed by freezing. It is carried out using liquefied gas, cooled to a temperature of -78 to -150 degrees. Cryodestruction of the cervix has a wide range of indications, it is used for erosions and cysts of the cervix, persistent chronic cervicitis, ectropion, leukoplakia, dysplasia and ectopia of the epithelium. It is a bloodless procedure that does not cause scarring in the cervix. It can be used at any age, including in young women planning a pregnancy. It is performed on an outpatient basis, does not require anesthesia.

Cryodestruction of the cervix (cryotherapy, cryoablation) is one of the most sparing surgical methods for treating cervical pathology. It has been used in gynecology since the late 1980s. Due to its simplicity, safety, low likelihood of complications and affordable cost, cryodestruction of the cervix does not lose its relevance to this day. The technique is based on the effect of local destruction of soft tissues under the action of ultra-low temperatures.

To freeze pathological foci during cervical cryodestruction, liquefied gases with a very low boiling point are used. In outpatient settings, nitrous oxide is most often used, the boiling point of which is - 89.5 degrees, since this gas is suitable for long-term storage. Rapid freezing of pathologically altered tissues during cryodestruction of the cervix is ​​provided by the Joule-Thompson effect. When it enters a wide tip from a narrow tube, liquefied gas expands and passes into a gaseous state, while the tip is cooled to -65-75 degrees.

The advantages of cryodestruction of the cervix are painlessness due to the analgesic effect of rapid tissue cooling, bloodlessness resulting from vasospasm, and point exposure, which allows the removal of pathological foci without affecting intact tissues. Cryodestruction of the cervix does not affect the elasticity of the cervix, so it can be used in the treatment of precancerous and background pathology in women of reproductive age. Experts note that a higher efficiency of cryodestruction of the cervix in young patients is observed in the treatment of precancer, and in the elderly - in the treatment of background diseases. The disadvantages of the method are the significant duration of healing (from 1.5 to 3 weeks), the inability to use for large foci and hard-to-reach neoplasia.

Indications and contraindications

As indications for cryodestruction of the cervix, primary and recurrent erosions and pseudo-erosions are considered in the absence of gross cervical deformity, chronic endocervicitis resistant to conservative therapy, cervical ectropion less than 3 cm in size, coagulated cervix syndrome, and epithelial dysplasia I and II degree. In addition, cryodestruction of the cervix is ​​used for polyps of the cervical canal and leukoplakia (in case of limited damage to the cervix without involving the vagina).

Cryodestruction of the cervix is ​​not carried out during menstruation, during gestation and lactation. As contraindications, metrorrhagia, cryoglobulinemia, grade III dysplasia, oncological diseases of the genital organs, uterine myoma, endometriosis, inflammation of the genital organs, low degree of vaginal cleanliness, specific infections, cervical ruptures that prevent close contact of the tip with the affected area, neoplasia larger than 3 cm, nodular and papillary formations. The use of cryodestruction of the cervix is ​​contraindicated in acute viral and bacterial infections and during an exacerbation of therapeutic pathology. The decision on the necessity and admissibility of the procedure is made by the gynecologist.

Preparation for cryodestruction

The procedure is carried out on an outpatient basis. Before the start of cryodestruction of the cervix, complaints are collected, anamnesis of the disease is ascertained, a gynecological examination and colposcopy are performed, swabs are taken to assess the degree of purity of the vagina, identify atypical cells and STDs. According to the indications, a biopsy is prescribed, followed by a histological examination. In some cases, the patient is recommended to do a pregnancy test.

For women of reproductive age, cryodestruction of the cervix is ​​carried out on the 7-10th day of the cycle. For the procedure in postmenopausal patients choose any convenient date. For several days, the patient should refrain from sexual relations. Before the procedure, it is necessary to carry out the toilet of the genital organs, 1-2 hours before the cryodestruction of the cervix, a non-steroidal anti-inflammatory drug should be taken. Immediately before using the technique, the doctor explains to the patient the essence and features of cryodestruction, warning about possible hot flashes during freezing of pathological foci and mild pain in the lower abdomen during or after the procedure.

Methodology

The patient is placed on a gynecological chair. The external genital organs and the walls of the vagina are treated with an antiseptic. The neck is cleaned with a swab soaked in saline. A swab moistened with a weak solution of acetic acid or Lugol's solution with glycerin is introduced, and the neck is processed again to identify altered areas. To perform cryodestruction of the cervix, a warm tip is inserted into the vagina, placed in the affected area and pressed so that the tip completely covers the area of ​​pathologically altered tissues. Turn on the circulation of liquefied gas and mark the time with a timer.

Within seconds, the tip cools rapidly and freezes the underlying tissue. Cryodestruction of the cervix is ​​continued for 3-5 minutes, then the circulation of the coolant is turned off and the tip is moved away from the treated area during thawing, slightly turning it at the time of separation (this avoids rupture of the cervix when the contact between the instrument and the frozen tissue is stopped). Make a pause for 4-5 minutes, then repeat the freezing for 3-5 minutes. After the end of cryodestruction of the cervix, white areas are formed at the site of pathological foci, in the area of ​​\u200b\u200bwhich subsequently zones of limited necrosis are formed. The neck is examined in mirrors and smeared with Monsel's paste.

After cryodestruction

After completion of the procedure, tachycardia, a feeling of heat and flushing of the face are possible. The listed symptoms are the result of tissue freezing, do not require special treatment and disappear within about 30 minutes. In some cases, after cryodestruction of the cervix, there is a rapid drop in blood pressure, bradycardia, cold sweat and pallor of the skin, combined with intense pain in the lower abdomen. When these symptoms are detected, diphenhydramine is administered to patients.

After normalization of the condition of patients who underwent cryodestruction of the cervix, they are allowed to go home. Sick leave is not required. In the first 1-2 days, pulling pains in the lower abdomen are possible. A number of patients develop hydrorrhea lasting up to 4 weeks. Within 3-5 days after cryodestruction of the cervix, naproxen, diclofenac or their analogues should be taken. Within 8 weeks, it is necessary to refrain from douching, intense physical activity, sexual intercourse, visiting the bath and sauna. Control colposcopy is carried out no earlier than 2 months after cryodestruction of the cervix, the optimal period is considered to be a study after 4 or more months.

The cost of cryodestruction of the cervix in Moscow

The cost of the technique is determined by the type of medical organization (private or public). In addition, the pricing takes into account the reputation of a multidisciplinary or specialized clinic, the level of training of specialists and the characteristics of the equipment used. If the patient wishes to undergo this procedure in a short time (without a queue), the price of cervical cryosurgery in Moscow may increase. In addition, an increase in the cost is noted with the expansion of the list of diagnostic studies, the appointment of consultations of narrow specialists (for example, when detecting somatic pathology) and the availability of additional services.