Cervix cryosurgery-Clinical Teaching.word file

Cervix cryosurgery- Clinical Teaching. This is Plan of Disease condition in Details.

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JG COLLEGE OF NURSING,
AHMEDABAD.
SUBJECT: OBSTETRIC AND GYNECOLOGICAL
NURSING-II
TOPIC : CLINICAL TEACHING






SUBMITTED TO: SUBMITTED BY:
MS. REKHAMOL SIDHANAR, PATEL SONAL P.

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ASSISTANT PROESSOR, s.Y M.SC NURSING, J.G COLLEGE
OF NURSING J.G COLLEGE OF NURSING
AHMEDABAD. AHMEDABAD.



Cervix Cryosurgery

Cervix cryosurgery is a surgical treatment to freeze and destroy abnormal tissue in
the cervix.
Cervical cryosurgery or cryotherapy is a gynecological treatment that freezes a section
ofthe cervix . Cryosurgery of the cervix is most often done to destroy abnormal cervical cells that
show changes that may lead to cancer. These changes are called precancerous cells. Your
gynecologist will probably use the term cervical dysplasia .
The surgery uses liquid nitrogen. When liquid nitrogen has a temperature between
-346 and -320 degrees Fahrenheit, it instantly freezes nearly anything it comes in contact with. In
the case of human tissue, it can kill and destroy cells upon contact. This is important when the
cells you want to kill are cancerous.
Typically used for tumors outside the body, cryosurgery is also used for certain tumors
inside the body. Advances in cryosurgery technology have dramatically reduced the long-term
side effects once associated with the treatment. The National Cancer Institute, however, claims
that more studies are needed on the long-term side effects and effectiveness of cryosurgery
(NCI).
Cryosurgery, also called cryotherapy, is similar to the technique used when doctors freeze off
warts.
Cryosurgery is done only after a colposcopy confirms the presence of abnormal cervical cells.
Cyrotherapy is also used for the treatment of cervicitis or inflammation of the cervix.
Cryosurgery is not a treatment for cervical cancer.

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Description
Cryotherapy is done in the doctor's office while you are awake. You may have slight cramping
and flushing in the face, however cryosurgery is mostly painless.

To perform the procedure:
 An instrument is inserted into the vagina to hold the walls open so that the doctor can see
the cervix.
 The doctor then inserts a device called a cryoprobe into the vagina. The device is placed
firmly on the surface of the cervix, covering the abnormal tissue.
 Compressed nitrogen gas flows through the instrument, making the metal cold enough to
freeze and destroy the tissue.

An "ice ball" forms on the cervix, killing the abnormal cells. For the treatment to be most
effective:
 The freezing is done for 3 minutes
 The cervix is allowed to thaw for 5 minutes
 Freezing is repeated for another 3 minutes

Why the Procedure is Performed
This procedure may be done to:
 Treat cervicitis
 Treat cervical dysplasia

Risks Associated With Cryosurgery
Cryosurgery does have risks and side effects, but they are considered lower than other cancer
treatments, such as surgery and radiation, according to the National Cancer Institute (NCI).
Risks associated with cryosurgery include:
 blisters
 damage to nearby healthy tissue
 infection
 loss of sensation if nerves are affected
 pain
 scarring

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 sexual dysfunction
 ulcers
 white skin where applied
 bleeding
 infection
Cryosurgery may cause scarring of the cervix, but most of the time it is very minor.
More severe scarring may make it more difficult to get pregnant, or cause increased cramping
with menstrual periods.

After the Procedure
health care provider should do a repeat Pap smear or biopsy at a follow-up visit to make sure that
all abnormal tissue was destroyed.
It may need more frequent Pap smears for the first 2 years after cryosurgery for cervical
dysplasia.

Outlook (Prognosis)
It might feel light-headed right after the procedure. If this happens, lie down flat on the
examination table so that you do not faint. This feeling should go away in a few minutes.
It resume almost all of your normal activities right after surgery.
For 2 - 3 weeks after the surgery, you will have a lot of watery discharge caused by the shedding
(sloughing) of the dead cervical tissue.
It may need to avoid sexual intercourse and using tampons for several weeks.
Avoid douching, because douching can cause severe infections in the uterus and tubes.

Why Cryosurgery Is Performed
Cryosurgery is used to destroy problem tissues in the body. In most cases of cancer, it is not the
first line of defense. However, it can be used when other forms of treatment have proven
unsuccessful, especially if the cancer has returned following other treatments.Cryosurgery is
most often performed to treat tumors on the skin. It is, however, used on some internal organs,
such as the liver, when disease and other problems make conventional surgery difficult or risky.
Cryosurgery is used as the primary treatment for early prostate cancer that is contained in the
prostate. It is also performed when cancer returns after other therapies.

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How to Prepare for a Cryosurgery
Your preparation for cryosurgery depends on the type of cryosurgery being performed.
Cryosurgery for skin cancer—the main reason cryosurgery is used—requires little preparation on
the part of the patient.
If your doctor will be treating an internal organ with cryosurgery, you will typically be given the
same instructions given before traditional surgery. You will be asked to fast 12 hours beforehand
and arrange for a ride home from the procedure.
Prior to the procedure, inform your doctor if you have an allergy to anesthesia, as well as any and
all medicine you are taking, including over-the-counter medications and nutritional supplements.
Your doctor will provide you with complete preparation instructions. It is important that you
follow them.

How a Cryosurgery Is Performed
Your doctor will place liquid nitrogen on your skin using a cotton swab or spray. A numbing
medicine may be used to prevent any pain or discomfort.
If an internal area is being treated, your surgeon will use a scope, which is a flexible tube that
can fit into various openings in your body, such as the urethra, rectum, or a surgical incision. The
liquid nitrogen is fed to the area under treatment and applied to the targeted cells. The cells
freeze and die and then will be slowly absorbed by your body.
Your doctor will use imaging equipment, such as an ultrasound, as a guide for carrying out the
procedure.

What happens during cryosurgery?
Cryosurgery is performed in your doctor's office while you are awake. It is similar to a pelvic
exam :
 you will be asked to undress from the waist down,
 lie on an exam table with your feet in stirrups,
 a speculum is inserted into your vagina to hold the vaginal canal open so that your cervix can
be seen.

However, that's where the similarity ends.

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 Cryotherapy uses special instruments called cryo probes.
 During cryosurgery the cyro probes are inserted into your vagina until they firmly cover the
abnormal areas of cervical tissue.
 Next, liquid nitrogen begins to flow through the cryo probes at a temperature of approximately
-50 degrees Celsius.
 This causes the metal cryo probes to freeze and destroy superficial abnormal cervical tissue.
 The most effective treatment result is obtained by freezing for three minutes, letting the cervix
thaw, and repeating the treatment for three more minutes.

Following Up After Cryosurgery
After most cryosurgeries, you can go home the same day. Some surgeries, namely complicated
internal ones, may require an overnight stay.
After the procedure, you’ll be tasked with caring for any incision wounds or places where skin
has been frozen. Your doctor will give you instructions for these, but care typically involves
keeping the area free of contaminants and changing the bandages to prevent infection.
You will have follow-up appointments where your doctor will determine how successful your
treatment was, if there were any complications, and whether you will need more cryotherapy.

What happens after cryosurgery?
You can return to most normal activities the day after cryosurgery ; however, there are a few
things you should take note of for the first two to three weeks following treatment:
 It is normal to experience a watery discharge for the first few weeks. This is caused by the
sloughing of dead cervical tissue.
 Do not insert anything into the vagina for at least two to three weeks. This means no tampons,
no douches, and no sexual intercourse.

You should call your health care provider if any of the following occur:
 Fever. Your doctor should inform you before you leave the office what amount of fever is
cause for alarm following cryosurgery.
 Vaginal bleeding that is heavier than you normally experience during your menstrual cycle.
 Pain. Some slight cramping is normal, however, any severe or increasing pelvic painshould
be reported to your doctor immediately.

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 Foul smell or yellowish vaginal discharge. These can indicate an infection which may need
immediate treatment.
Cryosurgery is relatively risk-free, producing fewer complications than any other gynecological
procedure. After cryosurgery you will need Pap tests every three to six months for a period of
time. Once you have had several normal Pap smears in a row, your doctor will discuss with you
how often you need future screening for cervical cancer.


BIBLIOGRAPHY
Books:
1. Basvanthappa B.T : “TEXT BOOK OF MIDWIFERY AND REPRODUCTIVE
HEALTH NURSING ”; first edition 2006, Jaypee brother publication, New
Delhi. Page no; 210-212.
2. Dutta D.C : “TEXT BOOK OF OBTETRICS ” ; 6
TH
Edition , 2004; New central
book agency publication, Calcutta. Page no: 169-172.
3. Jacob Anamma : “A COMPREHENSIVE TEXT BOOK OF MIDWIFEREEY ”;
1
st
edition 2005; Jaypee brother medical publication; New Delhi, page no:154-
162.
4. Kumari Neelam; (2010); 1
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edition; “MIDWIFERY AND GYNAECOLOGICAL
NURSING”; S.vikas and company; Jalandhar city; Page no :136-144.
5. Myles “ TEXT BOOK OF MIDWIVES ” ; Fourteenth edition, 2003; Elsevier
publisher, Philadelphia. Page no; 285-287.
6. Rao Kamini “TEXT BOOK OF MIDWIFERY AND OBSTETRICS FOR
NURSES”; First edition, 2011, Elsevier publisher, Philadelphia. Page no: 277-
281.

Websites:
 http://en.wikipedia.org/wiki
 http://www.medicinenet.com
 http://www.indiaparenting.com
 http://www.seasonsindia.com

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