Pain With Different Ablation Techniques in Healthy Cervical Tissue

21 Background: Traditional cryotherapy and thermoablation are safe and effective treatments for precancerous cervical lesions. Women can present with short-term pain during and after the procedures. Comparing conventional treatments with CryoPen (CryoPen, Corpus Christi, TX) will stablish efficacy and adverse effects with the goal of developing low-cost, effective treatments for developing countries. We undertook this work to determine pain after treatment with conventional cryotherapy with CO 2 , the CryoPen adapted for low-resource settings, and the thermocoagulator.Methods: One hundred twenty-five women age 25 to 65 years who were scheduled for hysterectomy for indications other than cervical pathology were randomly assigned to one of five treatment arms: single- and double-freeze arms for conventional cryotherapy and the adapted CryoPen, and a single application of thermoablation at 100° C for 40 seconds. Treatment was administered 12 to 24 hours before hysterectomy. By using the verbal numerical pain scale, treating physicians asked participants to rate their pain intensity from 0 to 10.Results: To date, 118 pain scores have been collected—23 single-freeze and 25 double-freeze conventional cryotherapy; 23 single-freeze and 25 double-freeze CryoPen; and 22 thermoablation. Pain ranged from 0 to 3 for single-freeze cryotherapy, 0 to 4 for double-freeze cryotherapy, 0 to 6 for single-freeze CryoPen, 1 to 8 for double-freeze CryoPen, and 2 to 8 for thermoablation. In descending order of median pain scores, thermoablation (3) was followed by double-freeze CryoPen (2.5), single-freeze CryoPen and double-freeze conventional cryotherapy (both 2), and single-freeze conventional cryotherapy ( Fig 1 ).Conclusion: Both conventional cryotherapy and CryoPen are less painful ablation techniques compared with thermoablation. Lower pain ratings for single-freeze compared with double-freeze strategies with both conventional cryotherapy and CryoPen support further research into the rationale for the traditional double-freeze regimen. [Figure: see text]AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST Karla Alfaro No relationship to disclose Ana Sofia Ore No relationship to disclose Albert Zevallos No relationship to disclose Manuel Salinas No relationship to disclose Jillian Garai No relationship to disclose Miriam Cremer Honoraria: Merck Speakers' Bureau: Merck