Reference Manual - IARC Screening Group

Treatment and FollowupStep 5Advise the woman regarding post-treatment care, warning signsand followup schedule.Step 6 Record her results of the treatment and when the patient isscheduled to return for followup in the patient’s record.Step 7Observe the woman for at least 15 minutes. Ask her how shefeels before sending her home.Step 8 Follow the instructions in Appendix D (page D-6) forprocessing the cryotherapy unit after use.ROUTINE FOLLOWUPPatient InstructionsMost women will not experience problems following cryotherapy.Advise the woman to expect some mild cramping and a clear (or lightlyblood-stained) watery discharge that usually lasts for up to 6 weeks. If itbecomes foul-smelling or pus-colored, or if she has pain, she shouldreturn to the clinic immediately to check for possible infection.Advise the woman that she should not douche, use vaginal tampons orhave sexual intercourse for 4 weeks, or until the discharge is completelygone. 9Note: If the woman will not be able to abstain from sexual intercourse,tell her to use condoms with every act of intercourse. Provide her with15–20 condoms.Advise her regarding the followup schedule and warning signs (Figure 7-7).Figure 7-7. Warning SignsIf you have any of the following, you should return to this or the nearest healthfacility:• Fever for more than 2 days• Severe lower abdominal pain, especially if you have a fever• Bleeding heavier than your heaviest days of menstrual bleeding for more than 2days• Bleeding with clots9 Because women who are seropositive for HIV may have increased shedding of the HIV following treatment and duringthe healing process, and because during this period women may be more likely to acquire HIV if exposed, abstinence forup to 4 weeks is strongly recommended for all women.Cervical Cancer Prevention Guidelines for Low-Resource Settings 7-19