Assessment of failures of cryosurgical treatment in cervical intraepithelial neoplasia.

The overall recurrence rate in 166 patients treated with cryosurgery is 10.8%. Recurrent cervical intraepithelial neoplasia is much more common in patients with severe dysplasia. Failures are commonly due to one of four factors. First, cryosurgery is to be used only after adequate colposcopic assessment and a negative endocervical curettage. Cryosurgery is a safe, effective treatment in selected patients, but consideration of surgical management should be given in the older patient who has completed childbearing, particularly those with severe dysplasia or carcinoma in situ. A full 7-minute freeze with optimum application of the cryoprobe to the full affected surface is essential. Careful follow-up of these patients is mandatory. The majority of failures occur within the first 12 months and probably represent persistent rather than recurrent diseases.