• Reference Number: HEY-669/2023
• Departments: Gynaecology
• Last Updated: 29 September 2023

Introduction

This leaflet has been produced to give you general information about your treatment. Most of your questions should be answered by this leaflet/booklet.  It is not intended to replace the discussion between you and your doctor but may act as a starting point for discussion.   If after reading it you have any concerns or require further explanation, please discuss this with a member of the healthcare team who has been caring for you.

What is a Cervical Ectropian?

Bleeding after sex and excessive vaginal discharge are usually caused by a process which affects the cervix. This is called an ECTROPION or ECTOPY.

This is a normal occurrence in which the delicate cells that line the cervical canal spread onto the surface of the cervix and become exposed. The cervix appears red because the cells that line the cervical canal are thinner compared to the thicker cells that are on the outside of the cervix.

These delicate cells are more likely to bleed whilst having sex or whilst taking a smear test. The cells also produce mucus to lubricate the vagina. If these cells are exposed, you may notice an increase in discharge.

Cervical ectropion is related to the hormone oestrogen. It is common in young women and those taking the oral combined contraceptive pill.

Why do I need Cryocautery?

Before undertaking treatment it is important to rule out infection, inflammation and the possibility of abnormality. This may include swabs and occasionally a biopsy may be taken from your cervix.

After investigations the ectropion may be treated if your symptoms are troublesome. A decision to treat your ectropion will depend on any tests that have been performed recently by your GP or any investigations performed in clinic.

You may decide that you do not wish to be treated. If so then the delicate skin on your cervix will gradually change into the thicker skin. The length of time for this to occur is unpredictable. You may therefore continue to have symptoms but can be reassured that you will come to no harm. It is important that you attend for your cervical sample when requested to do so.

What is cryocautery?

Cryocautery involves temporarily freezing the cervix with a metal probe for 1 minute.

It is sometimes used to treat mildly abnormal cells on the cervix but more often used to treat bleeding after sexual intercourse or excessive vaginal discharge.

Why do I need cryocautery?

Freezing this area on the cervix promotes growth of the tougher, thicker tissue. This tougher tissue is less likely to bleed during sex or produce excessive vaginal discharge. It is a quick simple treatment method and it will not affect your future fertility.

Can there be any complications or risks?

The complication rate of this procedure is very low. The most common complication is narrowing (stenosis) to the opening to the cervix. There is also a small risk of infection which is easily treated with antibiotics from your GP.

How do I prepare for Cryocautery?

Please read the information leaflet.  Share the information it contains with your partner and family (if you wish) so that they can be of help and support.  There may be information they need to know, especially if they are taking care of you following this examination. There are no health risks with this procedure.

What if I am having a period when my appointment is due?

It may not be possible to perform the cryocautery treatment if you are having a period and you may need to telephone to change your appointment. If this is the case the number to contact is (01482)624035/624031.

What if I am pregnant?

It will not be possible to carry out cryocautery to your cervix if you are pregnant. Please contact (01482)624035 to cancel your appointment.

What will happen?

You will be placed on a couch with your legs supported. An instrument called a speculum is inserted in the vagina so that your cervix can clearly be seen.

A small, cold metal probe is placed onto the cervix for 1 minute. During this time, you may experience some period type discomfort. This discomfort may last for the rest of the day.

Local anaesthetic is not required for this procedure. Simple painkillers, such as paracetamol or ibuprofen usually help with the discomfort. We recommend that you take them prior to the procedure.

What happens afterwards?

You will be able to go home 15 minutes after the treatment if you feel able. You can drive a car or take public transport. I

t is normal to experience a heavy watery discharge for the first few days. This watery discharge may last for up to 4 weeks. It may change from pink to brownish in colour. The discharge should not be yellow or foul smelling. If this occurs you must see your doctor who can prescribe you antibiotics.

In order to reduce the risk of infection during the first 4 weeks you must:

• Use sanitary towels and not tampons.
•  Avoid sexual intercourse.
•  Avoid swimming.
•  Avoid vaginal creams

You must contact your GP or the Gynaecology Department on (01482) 607893 if you have any of the following:

•  A smelly discharge.
•  Fever or high temperature.
•  Heavy vaginal bleeding.
•  Severe abdominal pain.

Will I need a follow up appointment?

It will be up to the clinician who treated you as to whether you need to be seen again in clinic. An appointment will be sent to you if required.

Should you require further advice on the issues contained in this leaflet, please do not hesitate to contact:

Sarah Bolton/Charlie Fear Nurse Colposcopists – (01482) 382644

Gynaecology Outpatients Department, (Monday to Friday 8.00am to 5.00pm) – (01482) 607829 

Cedar Ward (Gynaecology) – (01482) 604387

Colposcopy Office (Monday to Friday 9.00-5.00pm) – (01482) 624013/624035

NHS Direct www.nhsdirect.nhs.uk  – 08454647

General Advice and Consent

Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.

Consent to treatment

Before any doctor, nurse or therapist examines or treats you, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to you. You should always ask them more questions if you do not understand or if you want more information.

The information you receive should be about your condition, the alternatives available to you, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:

• you must be able to give your consent
• you must be given enough information to enable you to make a decision
• you must be acting under your own free will and not under the strong influence of another person

Information about you

We collect and use your information to provide you with care and treatment. As part of your care, information about you will be shared between members of a healthcare team, some of whom you may not meet. Your information may also be used to help train staff, to check the quality of our care, to manage and plan the health service, and to help with research. Wherever possible we use anonymous data.

We may pass on relevant information to other health organisations that provide you with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your doctor, or the person caring for you.

Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about you. For further information visit the following page: Confidential Information about You.

If you or your carer needs information about your health and wellbeing and about your care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.