Cervical Cryotherapy:
It is an ablative method used in the elimination of cervical intraepithelial lesions and cervical wounds. It uses compressed gas to create extremely cold temperatures that necrose the cervix epithelium.
How does it work?
As the gas expands, it absorbs heat from its surroundings. As the cervix cools, a layer of ice called an iceball forms under the probe and grows circumferentially beyond the boundaries of the probe. Cell death, that is, necrosis, develops up to 2 mm from the border of the iceball. When nitrogen is used it cools down to -65 degrees. - Cell death occurs at 20 degrees.
In which patients is it preferred?
It is generally preferred in cervical dysplasias that do not go deeper than 5 mm, that do not affect more than half of the cervix, that have been adequately evaluated by colposcopy, that do not involve the glands, and in cervical erosions called cervical wounds. It is not preferred in the treatment of CIN III.
How is it done?
It does not require anesthesia during the procedure. Non-steroidal analgesics such as Naproxen sodium etc. taken 30-60 minutes before the procedure also reduce uterine cramps during the procedure.
The patient is prepared in the gynecological examination position and an examination instrument called a speculum is placed. Thus, the cervix can be seen clearly. Water-based gel is applied to the tip of the probe to ensure equal tissue contact and the problem is pressed tightly against the cervix. During the procedure, contact of the probe with the vaginal walls should be avoided. By pressing the trigger, the problem and the cervix are expected to form an ice ball that will extend beyond 7 mm. By releasing the trigger, the cervix is expected to completely dissolve and release the probe, and the procedure is repeated after a 5-minute break.
Especially in dysplasias, the risk of luxation increases in the first year when double freezing is not applied.
Dizziness due to vasovagal stimulation after the procedure. visible. The patient should be seated slowly.
What should be the care after the procedure?
Excessive watery and slightly bloody discharge is normal after the procedure. Pads are used, but tampons are not recommended. Spotting may continue for several weeks. Inguinal and lower abdominal pain may occur in the first few days and is relieved with non-steroidal painkillers. can be done. Rarely, the cervix may become blocked and pain may occur due to pressure. This obstruction can be easily opened. Due to the risk of infection, a 4-week sexual intercourse ban should be observed. Even if avoidance is not possible, a condom should be used.
Cryotherapy for external genital lesions:
Warts and molluscum in the external genital area. Cryotherapy can also be used for acne-like lesions. It is superior to cautery in that it requires less local anesthesia and better cosmetic results. The lesion is frozen in a millimetric area by cooling the compressed gas by spraying it with the help of thin tips.
After the procedure, the lesion crusts over and disappears with the healing process.
Laser use in gynecology:
Laser It has a wide range of usage in gynecology. In the treatment of vaginal tightening and urinary incontinence, laser is applied with the help of a cap placed inside the vagina and results are obtained with 3-4 sessions of application at 2-3 week intervals. Darkening in the external genital area is an undesirable situation for many women, and many factors such as metabolic or hormonal conditions, tight underwear and trousers can cause this. The genital area can be returned to its normal color by lightening the color in 3-4 sessions with laser. Deformation and sagging problems in the shape of the small lips can also be corrected with laser without bleeding. Lesions such as warts and molluscum in the external genital area can also be treated with laser.
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