Atlas of Colposcopy: Principles and Practice

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Treatment by cryotherapy – Post-treatment advice and follow-up  

Post-treatment advice:
  • The woman should be counselled that she will have a clear or slightly bloodstained watery vaginal discharge that can persist for up to 2–4 weeks, and she will have to use sanitary towels.
  • The woman should be informed of the following warning signs:
    • foul-smelling, purulent discharge
    • fever for more than 2 days
    • severe lower abdominal pain, especially if accompanied by fever
    • excessive vaginal bleeding (other than the blood loss during normal menstruation)
    • bleeding with clots.
  • If the woman develops any of the above-mentioned symptoms, she should attend the colposcopy centre or seek medical attention elsewhere.
  • The woman should be advised not to have sexual intercourse for 4–6 weeks, or until the watery discharge disappear completely.
    (Note: If the couple is unable to abstain from sexual intercourse, they should use a condom.)
  • The woman should be advised regarding the follow-up schedule.
Note: Antibiotics are not routinely prescribed after cryotherapy. Paracetamol tablets may be given for 1 or 2 days for pain.

Follow-up after cryotherapy:
  • The woman may be advised to come back for a check-up after 6 weeks to 3 months to exclude infection or other complications. No screening or speculum examination or colposcopy should be done. The biopsy report, if available, should be reviewed. In a screen-and-treat programme, this follow-up visit is often omitted.
  • The next check-up should be done after 8–12 months, when the woman may have the screening test originally performed or a direct colposcopic examination.
  • If there is a persistent lesion at follow-up, it is preferable to excise the lesion, although cryotherapy may be repeated if the usual criteria for cryotherapy are fulfilled.

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