Dr. Keri L. M. K. Brown, MD

Cryotherapy is the targeted use of extreme cold to destroy unhealthy or unwanted tissue. The doctor applies the cold on the skin or injects it through a needle to reach the inside of the body, where it freezes away the problem tissue. Cryotherapy is often used to remove minor skin problems such as warts or skin tags, and it is also used to treat some small tumors.

To achieve the cold temperatures needed for cryotherapy, liquid nitrogen or argon gas is passed through a tube, which becomes cold enough to freeze cells on contact. Alternatively, liquid nitrogen can be swabbed directly onto the skin or via a spray, which applies only a specific, small amount to the skin at a time.

Because the area treated is typically very small, cryotherapy is not usually painful. There may be a sensation of cold and possibly some slight discomfort. Cryotherapy is very fast and can easily be performed in a doctor's office. It also doesn't require stitches, because there is no cutting involved. These benefits make cryotherapy a good choice for many issues, including:

• Common warts
• Genital warts
• Skin tags
• Age spots
• Some skin cancers
• Cervical cancer
• Prostate cancer
• Retinoblastoma, cancer that occurs in the eye

A hysteroscopy is a diagnostic procedure performed to examine the inside of the uterus. A thin tube with a camera and light at the end, called a hysteroscope, is inserted through the vagina. It allows the physician to view the cervix and uterine walls. Sometimes, gas or liquid is used to expand the uterus and allow a better view. If necessary, tiny instruments can also be passed through the tube and used for certain procedures, such as taking a biopsy or removing a polyp.

Hysteroscopy is often done to figure out the cause of abnormal menstrual bleeding. However, it can also be used to:

• Identify the cause of recurrent miscarriage
• Remove polyps or fibroids, non-cancerous growths in the uterus
• Remove adhesions, scar tissue within the uterus
• Identify uterine septums, a wall of tissue dividing the uterus
• Perform ablation, the removal of excess uterine lining

A pessary is a device that is inserted into the vagina to relieve symptoms associated with mild to moderate pelvic organ prolapse, a condition in which the womb, bladder, or rectum bulges into the vaginal canal. This device is made of either rubber or plastic and is a safe, nonsurgical way to provide support for prolapsed organs.

Pessaries come in different shapes and sizes, and finding the right one can take some trial and error. Before a pessary fitting, patients will be examined and evaluated based on prolapse-related symptoms they may be experiencing, which may include discomfort, urine leakage when sneezing or coughing, and trouble keeping tampons in.

The following tips can help guide the process of finding the right fit:

• Once in place, patients should not be able to feel the device at all. If there is even slight pressure, patients should let their healthcare provider know, and she will find a pessary of a different size or shape.
• The pessary should not fall out with sneezing, coughing, jumping, or squatting. While getting fitted, patients should try jumping or squatting to see if the device will fall out. If it does, a different pessary will be inserted until they find one that stays in place.
• Patients and their healthcare providers should make sure the device is improving symptoms by having a check-up 5 to 15 days after it is inserted. If there is no improvement, patients may have to be re-fitted with a different pessary, or patients may be asked to consider surgical options.