Role of Cryotherapy in the Management of Cervical Ectropion: A Comprehensive Review

Cervical ectropion, also known as columnar epithelium on the vaginal portion of the cervix, is one of the common benign conditions that occur in women of reproductive age. Although generally asymptomatic, symptomatic CE can cause painful symptoms such as vaginal discharge, itching, dyspareunia, and post-coital bleeding, and could potentially increase the risk of infection with HPV and cervical dysplasia. Cryotherapy is inexpensive and minimally invasive, and widely used for symptomatic CE. Double-freeze cycle of liquid nitrogen at extremely low temperatures in liquid nitrogen freezes the affected tissue and destroys ectopic epithelium. Cryotherapy is easy, well-tolerated, and may be performed without anesthesia and on an outpatient basis. There are published studies that show a high efficacy rate of up to 98% for resolution of ectropion with symptom relief of 95% in the treated patients. General side effects include cramping and copious vaginal discharge and, in general, resolve spontaneously over weeks. Other complications that include cervical stenosis and infection are unusual but can occur with more significant outcomes. Cryotherapy remains a treatment of choice because of high success rates and minimum side effects and it is very inexpensive, therefore highly advantageous in low-resource settings, where the accessibility of more advanced treatments may be limited. More advanced cases or lesions far in the cervical canal of cases may not be adequate enough to be treated through cryotherapy; however, it is usually effective for most women who experience symptomatic cervical ectropion.