We found no evidence that cryosurgery improved clinical outcomes. Weak evidence from methodologically flawed case series suggested that cryosurgery may reduce biochemical and histological markers of disease from pre-intervention levels, although the clinical importance of such a reduction is unclear. We found no controlled trials comparing cryosurgery with other treatments. Cryosurgery is associated with important adverse effects, particularly impotence, and remains an experimental treatment until well-designed randomised controlled trials provide evidence of its clinical effectiveness.