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VNA of Care New England

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
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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

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