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by Aaron S
(Cone Biopsy; Cervical Cone Biopsy)

Definition

Cervical conization is the removal of a section of the cervix. The cervix is the lower part of the uterus. This procedure accesses the cervix through the vagina.

Reasons for Procedure

A cervical conization may be used as part of diagnosis or treatment. It can remove a sample of abnormal cervix tissue. The sample will then be sent to a lab to look for abnormal cells like cervical cancer. It is often used after an abnormal pap smear.

Conization can also remove abnormal tissue. It may be done as part of treatment.

Cervix with Precancerous Growth
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Possible Complications

Complications are rare, but no procedure is completely free of risk. The doctor will review a list of possible problems such as:

  • Infection
  • Bleeding
  • Early delivery with future pregnancies
  • Scarring of the cervix

Things that increase the risk of problems from the surgery include:

What to Expect

Prior to Procedure

You may need to stop eating or drinking 8 hours prior to the procedure.

Anesthesia

Anesthesia will depend on how much tissue will be removed. Options include:

  • Local anesthesia—The area will be numbed. IV medicine 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 flat tool will be inserted into the vagina and gently opened. It will allow tools to pass easier to the cervix. A knife, laser, or heated loop will remove a cone-shaped area of tissue. The doctor may remove all abnormal cells that can be seen or just a section for testing. Stitches may be placed to control bleeding. The stitches will fade and be absorbed by the body.

The tissue will be sent to a lab. The test results 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. There may be cramping and pain for a few days. Medicine should help to manage it.

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

It will take about a week to return to normal activity. It will take about 4 to 6 weeks for the area to fully heal. A follow-up exam may be done in 6 weeks.

Call Your Doctor

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

  • Signs of infection, including fever, chills, or foul-smelling discharge from vagina
  • Heavy vaginal bleeding (can happen a week after procedure)
  • Belly or pelvic pain that is getting worse

If you think you have an emergency, call for emergency medical services right away.

RESOURCES

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  http://www.sogc.org 

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

References

Basu P, Taghavi K, Hu SY, Mogri S, Joshi S. Management of cervical premalignant lesions. Curr Probl Cancer. 2018 Mar;42(2):129

Cervical Cancer: Surgery. American Cancer Society website. Available at: http://www.cancer.org/Cancer/CervicalCancer/DetailedGuide/cervical-cancer-treating-surgery. Updated January 3, 2020. Accessed March 25, 2020.

Massad LS, Einstein MH, Huh WK, et al; 2012 American Society for Colposcopy and Cervical Pathology Consensus Guidelines Conference. 2012 updated consensus guidelines for the management of abnormal cervical cancer screening tests and cancer precursors. J Low Genit Tract Dis. 2013 Apr;17(5 Suppl 1):S1-S27.

Management of Cervical Intraepithelial Neoplasia (CIN) and Adenocarcinoma In Situ (AIS). EBSCO DynaMed website. Available at:  https://www.dynamed.com/management/management-of-cervical-intraepithelial-neoplasia-cin-and-adenocarcinoma-in-situ-ais . Updated July 30, 2018. Accessed March 25, 2020.

6/3/2011 DynaMed Systematic Literature Surveillance  https://www.dynamed.com/topics/dmp~AN~T905141/Treatment-for-tobacco-use : Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.e8.

Revision Information

  • Reviewer: EBSCO Medical Review Board Mary-Beth Seymour, RN
  • Review Date: 09/2019
  • Update Date: 09/25/2020