Your Health - Cervical Conization

Cervical Conization

(Cone Biopsy; Cervical Cone Biopsy)

Pronounced: cervical cone-ih-zay-shun

Definition

Cervical conization is done to remove a cone-shaped piece of tissue from the cervix. The cervix is located at the back of the vagina and is the entry way into the uterus (womb).

Reasons for Procedure

A cervical conization is used to diagnose and often treat cervical cancer or precancerous changes in the cervix. The procedure takes place after a woman has had abnormal pap smears. Pap smears are a screening test to detect abnormal cells, pre-cancerous and cancerous cells in the cervix.

Cervix With Precancerous Growth

Possible Complications

Complications are rare but no procedure is completely free of risk. If you are planning to have a cervical conization, your doctor will review a list of possible complications which may include:

Infection
Bleeding
Premature delivery with future pregnancies
Scarring of the cervix

What to Expect

Prior to Procedure

Do not eat or drink anything for 8 hours prior to the procedure.

Anesthesia

You will be given some type of anesthesia. These options include:

Local anesthetic—the area will be numbed; IV sedation may also be given to help you relax
Regional anesthesia (epidural, spinal)—the lower half of the body will be numb
General anesthesia —you will be asleep

Description of the Procedure

A speculum will be inserted into the vagina, similar to a Pap smear. It will hold your vagina open and allow instruments to pass easier. Your doctor will use a knife, laser, or heated loop to remove a cone-shaped piece of tissue from the cervix. If there are abnormal cells they will also be removed. Self-absorbable sutures may be placed in the cervix to control bleeding.

The tissue will be sent to a lab to test for cancer. The test result will be available within a week.

How Long Will It Take?

The procedure will take less than an hour.

How Much Will It Hurt?

Anesthesia will prevent pain during this procedure. After the procedure, you may have some discomfort. You can take pain relievers to help manage any discomfort.

Postoperative Care

At the Care Center

You will rest in a recovery area until the anesthesia wears off. When you are awake and aware you will be able to go home.

At Home

When you return home, do the following to help ensure a smooth recovery:

You may have some bleeding or discharge from your vagina for several days postsurgery. A sanitary napkin or pad may be worn. Tampons should not be used for a month or more after the surgery.
Sexual intercourse is discouraged for 4-6 weeks.
Showers and baths are OK.
Be sure to follow your doctor's instructions.

A postoperative exam takes place at six weeks.

Call Your Doctor

After arriving home, contact your doctor if any of the following occurs:

Signs of infection, including fever, chills, or smelly discharge from vagina
Heavy vaginal bleeding (This may not occur until about one week after the operation, when the healing scar is shed from the cervix.)
Abdominal or pelvic pain that worsens

In case of an emergency call 911.

RESOURCES:

The American College of Obstetricians and Gynecologists
http://www.acog.org/publications/patient_education/

National Cancer Institute
http://www.cancer.gov/

National Cervical Cancer Coalition
http://www.nccc-online.org/

CANADIAN RESOURCES:

The Society of Obstetricians and Gynaecologists of Canada (SOGC)
http://www.sogc.org/

Women's Health Matters
http://www.womenshealthmatters.ca/index.cfm

References:

Cold knife cone biopsy. MedlinePlus Medical Encyclopedia website. Available at: http://www.nlm.nih.gov/medlineplus/ency/article/003910.htm . Accessed August 30, 2005.

Morris M, Mitchell MF, Silva EG, et al. Cervical conization as definitive therapy for early invasive squamous carcinoma of the cervix. Gynecol Oncol . Nov 1993;51(2):193-6.

Stenchever MA. Comprehensive Gynecology . 4th ed. St. Louis, MO: Mosby; 2001:878-880.

Last reviewed November 2009 by Ganson Purcell,Jr., MD, FACOG, FACPE

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.