Cervical Conization

(Cone Biopsy; Cervical Cone Biopsy)
  • Definition

    Cervical conization is done to remove a cone-shaped piece of tissue from the cervix. The cervix is located at the top of the vagina and is the entryway into the uterus (womb).
  • Reasons for Procedure

    A cervical conization is used to diagnose and to treat cervical cancer or precancerous changes in the cervix. The procedure takes place after a woman has had abnormal Pap smears. Pap smears are screening tests to detect abnormal, pre-cancerous, and cancerous cells in the cervix.
    Cervix With Precancerous Growth
    Nucleus factsheet image
    Copyright © Nucleus Medical Media, Inc.
  • 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
    Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications such as:
    • Smoking
    • Drinking
    • Chronic disease such as diabetes or obesity
  • 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 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. 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.
    During your stay, the hospital staff will take steps to reduce your chance of infection such as:
    • Washing their hands
    • Wearing gloves or masks
    • Keeping your incisions covered
    There are also steps you can take to reduce your chances of infection such as:
    • Washing your hands often and reminding visitors and healthcare providers to do the same
    • Reminding your healthcare providers to wear gloves or masks
    • Not allowing others to touch your incisions
    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 for medical help 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 (SOGC) http://www.sogc.org

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

    References

    American College of Obstetricians and Gynecologists. Management of abnormal cervical cytology and histology. Practice Bulletin. 2008;99.

    Cervical Cancer: Surgery. American Cancer Society website. Available at: http://www.cancer.org/Cancer/CervicalCancer/DetailedGuide/cervical-cancer-treating-surgery. Updated August 2010. Accessed November 18, 2010.

    Fernandez-Montoli ME, Baldrick E, Mirapeix G, et al. Conservative treatment in gynaecological cancer for fertility preservation. Cochrane Gynaecological Cancer Group. Cochrane Database of Systematic Reviews. 2010;(8).

    Morris M, Mitchell MF, et al. Cervical conization as definitive therapy for early invasive squamous carcinoma of the cervix. Gynecol Oncol. 1993;51(2):193-196.

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

    6/3/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: 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

  • Connect with Steward

    Visit Our Twitter Feed Visit Our Facebook Page Email This Page Print This Page
    Subscribe to Believe: Our e-newsletter

    Subscribe to Believe

    Our electronic health news
    Copyright © 2014 Steward Health Care
    Connect Healthcare Panacea CMS Solutions