Aug. 29, 2000 -- The doctor may say "You may experience some mild discomfort," but sometimes the healing process after a medical procedure can be more than you bargained for. Now a group of researchers conclude that for cryosurgery to treat abnormal cells on the cervix, this is often the case.
Cryosurgery is one of only a handful of ways to treat and remove abnormal cells on the cervix -- called dysplasia -- which, if left untreated, can turn into cancer. During cryosurgery, the abnormal tissue on the cervix is frozen with liquid nitrogen -- the freezing kills the questionable cells.
The procedure, which lasts less than 15 minutes, is not used if cancer is suspected. The side effects include heavy watery discharge, a bad smell, and some cramping and pain.
Diane M. Harper, MD, MPH, and colleagues followed more than 80 women who had the procedure to see just how they were impacted by the effects of the surgery. The results of their study appear in the Aug. issue of The Journal of Family Practice.
"We did the study because in doing the consent form for women prior to a cryosurgical procedure, [physicians] need to be able to describe what the procedure is," Harper tells WebMD. In doing so, women will know what to expect from the procedure and its possible side effects. Harper is an associate professor of obstetrics and gynecology at Dartmouth College Medical School in Lebanon, N.H.
Of the potential side effects, the researchers found that body odor was reported by almost three-quarters of the women and lasted for about eight days.
"Often, women would come back three to four days later saying that they smelled something like death. What it was, was the dead tissue sloughing off, and until it sloughs off, it has this very bad odor associated with it. And truly only the woman can smell it, but for her it is a huge thing," Harper says.
Another important side effect is the amount of watery discharge a woman expels, requiring in many cases the use of sanitary pads. In the study, researchers found that women required sanitary pads for about 12 days. "We knew that there would be discharge, but we didn't know the quantity of it, so we couldn't give women an accurate idea beforehand of what to expect," says Harper, who also is associate professor of community and family medicine at Dartmouth. "Discharge is part of the healing process."
Some women in the study experienced pain and cramping lasting about five days. "Cramping is something we were surprised at how often it happens," Harper says. "A common misconception that physicians have is that women have no nerve ending in the cervix, so they can't feel anything."
Overall, when the researchers surveyed the women, they found the experience with cryosurgery was unpleasant for almost 80% due to the pain and cramping, the discharge, the necessity of wearing pads for protection, and the odor. Compared to the inconvenience of a normal period, the aftereffects of cryosurgery were judged to be more severe, causing almost 40% to restrict their activities.
Of special note, obese women, women who had had children, and older women fared the worst: These groups reported they were more bothered by their symptoms.
Charles Dunton, MD, tells WebMD. "If women know the things they are experiencing are not unusual, their anxiety level goes down and they are able to tolerate the side effects of the treatment. They know it is not a complication, that they are not unusual, and it is easier for them to say 'OK, this is what I am supposed to expect.'" Dunton, a professor in the department of ob-gyn at Jefferson Medical College in Philadelphia, wrote an accompanying editorial.
Harper agrees and says that physicians need to do a better job of letting women know what to expect from cryosurgery. "Making this very clear to [patients] will lead to a much better relationship with the doctor as well as to potentially better outcomes for future health care."