After an abnormal Pap smear, a clinician may proceed with a colposcopy to further investigate the cervix and may decide to take a biopsy. Cryosurgery is an ablative treatment that destroys abnormal tissue by freezing. A probe is placed against the cervix, cooling it to sub-zero temperature with liquid nitrogen or carbon dioxide. Dead cells are then shed over a period of time. All of the dysplasia is removed, preferably in one sweep, preserving the abnormal tissue for histologic interpretation.
Local anesthesia is used, and there is a small risk of excessive bleeding.
While there is a large body of research concerning cryosurgery and LEEP separately, only one study was identified that compared their dysplasia recurrence rates. This study appears to be a strong study and well designed. Because the data were compiled from multiple studies, the potential for accurate comparison of dysplasia recurrence rates is limited. In a non-experimental study looking at LEEP performed by family physicians, there were numerous reports of unexpected discoveries of invasive carcinoma. We hypothesize that LEEP will have a lower dysplasia recurrence rate than cryosurgery.