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Cervical cryosurgery (freezing of cevix)

[Indications]
1. Chronic cervicitis.
2. Cervical endometriosis.
3. Mild to moderate cervical intraepithelial neoplasia.
[Contraindications]
1. Acute vulvar, vaginal, cervical or (and) pelvic inflammatory disease.
2. Severe cervicitis, malignant transformation is not excluded.
[Preoperative preparation]
1. Routinely perform cervical smear examination to find cancer cells, and those with suspicious clinical and cytological examinations should undergo cervical biopsy.
2. People with acute genital inflammation should take anti-inflammatory treatment first.
3. No sex life for 3 days before surgery.
[Surgical steps and technical points]
1. Body position: lithotomy position.
2. Disinfection: routinely disinfect the vulva, vagina, and cervix, and fully expose the cervix.
3. Cervical freezing: According to the scope of cervical lesions and the lesions of the external cervical os, select the appropriate freezing probe, so that the freezing coverage slightly exceeds the scope of the lesion by 2mm. Press the freezing probe tightly against the lesion, start the freezer, and use the 3-3-3 method or the 3-5-3 method, that is, when the local temperature is -180 °C, the time is calculated, the freezing lasts for 3 minutes, and the natural rewarming is performed. 3 to 5 minutes, and then repeated freezing for 3 minutes.
After natural rewarming, take out the cryoprobe and speculum after the probe is completely separated from the cervical tissue. It is strictly forbidden to forcibly tear the probe before it is completely separated from the cervix, so as to avoid tissue damage and bleeding.
[Features of this technique]
Using a refrigerant (usually liquid nitrogen), the local diseased tissue is repeatedly frozen and thawed, necrotic or degenerated and falls off, and then the tissue is repaired to achieve the purpose of treatment. Its features:
1. During freezing, the microcirculation in the tissue is blocked and stopped, and the local bleeding during and after the operation is less.
2. Quick freezing and slow and natural rewarming after freezing, have greater lethality to cells.
3. There will be no local scars after the frozen part is healed, which is especially suitable for the treatment of cervical lesions of reproductive women.
[Postoperative care]
1. Routinely give antibiotics and hemostatic drugs for 3 days.
2. Within two weeks, there will be a lot of light red watery fluid discharged from the vagina, which is a normal phenomenon and does not need to be treated.
3. No sex life within two months.
4. Two-month review, if the wound is not completely healed, a second superficial cautery can be performed.