Reference Manual - IARC Screening Group

Talking with Women About Cervical CancerTable 4-1. Expected Side Effects of CryotherapySide EffectManagementCramping • Counsel patient before the procedure to expect somedegree of cramping during and after the procedureand that cramping usually stops shortly afterprocedure.• Reduce cramping by pressing lightly on the cervixwith the cryotherapy probe.• If cramping is severe, provide oral analgesic(acetaminophen or ibuprofen).Vaginal discharge(profuse, watery)• Counsel patient to expect a discharge lasting 2–4weeks. Provide patient with undergarment andfeminine pads. a• Counsel patient to expect discharge to change colorfrom a pink tint to clear white or a yellow tint(occasionally streaked with blood).• Counsel patient to return if discharge changes tofoul-smelling or is pus-colored (if so, evaluate forinfection and treat with antibiotics).• Strongly advise abstinence from sexual intercoursefor 4 weeks.• If abstinence is unlikely, advise condom use for 4weeks to prevent pelvic infection.Spotting/light bleeding • Counsel patient to expect spotting/light bleeding for1–2 weeks.• Counsel patient to return for evaluation if there isheavy bleeding.aIf undergarments or feminine pads are not available, cloth or other soft material may beused.• Allow time for and encourage the woman to ask questions anddiscuss her condition.• Ask the woman if she gives consent for treatment.A woman with evidence of precancerous cervical changes (VIA testpositive)should be given the above information plus additionalinformation about STIs and how to prevent them.COUNSELING FOLLOWING CRYOTHERAPYBefore leaving the health facility, a woman should receive counselingregarding:• the details of self-care at home,• conditions that might require coming to the clinic as soon as possiblefor care outside of the scheduled visits (Figure 4-1),4-6 Cervical Cancer Prevention Guidelines for Low-Resource Settings