[Cryotherapy in the management of symptomatic cervical ectopy]

To demonstrate that cryotherapy is a powerful method to treat symptomatic benign ectopy of the uterine cervix.

Sixty-five patients with benign ectopy of the uterine cervix were recruited at the colposcopy clinic of Belfort's hospital (France) between July 2002 and August 2003. Women with ectopy were treated for four main symptomatic reasons: abundant leucorrhoea, contact bleeding and recurrent cervicitis and also pelvic pain. Cryosurgery consisted in the use of nitrogen oxide at -89 degrees C to destroy the ectopic columnar epithelium by freezing, transmitted to the lesion through a flat cryode. Neither anaesthesia nor analgesia was required. A colposcopic examination was realised three to six months later (N = 63). If there remained residual symptoms or ectopy, cryotherapy was used once more.

Indications to treat were 92,3% for abundant leucorrhoea, 21,5% for contact bleeding, 6,2% for recurrent cervicitis, 4,6% for pelvic pain and 4,6% for abnormal cervical smears. Two cryosurgery procedures were necessary in only 27,7% of cases. A symptomatic cure rate of 95,2% was obtained and ectopy completely disappeared in 98,4% of cases. The ratio "size of the residual ectopy/size of the initial lesion" varied from 12,5% to 50%. After treatment, no severe complication was observed except hydrorrhoea for a few days.

Cryotherapy remains one of the best methods to treat symptomatic ectopy of the uterine cervix. Moreover, it is a technique which is easy to acquire and practise and which is completely painless for women.