Pronounced: cervical cone-ih-zay-shun
by Shara Aaron, MS, RD
En Espaol (Spanish Version) Surgical procedure to remove a cone-shaped piece of tissue from the cervix. The cervix is located at the bottom of the uterus and contains the opening to the vagina.
Uterine cervix
A cervical conization is used to diagnose and often treat a condition in the cervix such as cancer or precancerous changes. The procedure takes place after a woman has had abnormal pap smears , which detect cancerous changes or abnormal cells in the cervix.
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A slight risk for infection, excessive bleeding, and scarring of the cervix may occur with cervical conization.
Do not eat or drink anything for 6-8 hours prior to the procedure.
You will be given some type of anesthesia. These options include:
- Local anestheticinjected into the tissues surrounding the cervix with or without the addition of intravenous sedation
- Regional anesthesia (epidural, spinal)will numb the lower half of the body
- General anesthesia will put you to sleep through the duration of this procedure.
After you are given anesthesia, your doctor will insert a speculum similar to that used for a Pap smear. It will hold your vagina open and allow instruments to pass easier. A cone-shaped piece of tissue is then removed from the cervix by knife, laser, or a heated electrocautery loop. The tissue will be sent to the pathology lab to test for cancerous cells. The cutting of the tissue can also be used as treatment for the elimination of the abnormal, precancerous cells. Self-absorbable sutures may be placed in the cervix to control bleeding.
After ProcedureYou will wait for the anesthesia to wear off and most likely be discharged from the hospital the same day.You may have some bleeding or discharge from your vagina for several days postsurgery. A sanitary napkin or pad may be worn; tampons are not to be worn for a month or more postsurgery.You may be given pain relievers.Sexual intercourse is discouraged for 4-6 weeks. How Long Will It Take?The procedure takes less than an hour. Will It Hurt?Because you are under anesthesia during this procedure, you should not feel any pain. After the procedure, you may have some discomfort, for which you can take pain relievers. Possible ComplicationsInfection of the cervical wound siteHeavy bleeding from the vaginaPremature delivery with future pregnancies Average Hospital StayThe procedure requires a several-hour stay in the hospital with a discharge the same day. Postoperative CareActivities that risk the integrity of the cervical tissue, such as intercourse or tampon use, must be limited. A postoperative exam takes place at six weeks. OutcomeConization completely removes the abnormal cervical tissue in 60%-90% of cases. Call Your Doctor If Any of the Following OccursHeavy bleeding from the vagina (This may not occur until about one week after the operation, when the healing scar is shed from the cervix)Signs of infection (eg, fever, chills, smelly discharge from the vagina) RESOURCES:
American College of Obstetricians and Gynecologistswww.acog.org/ National Cancer Institutehttp://www.cancer.gov National Cervical Cancer Coalitionhttp://www.nccc-online.org CANADIAN RESOURCES: The Society of Obstetricians and Gynaecologists of Canada (SOGC)http://www.sogc.org Women's Health Mattershttp://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. Comprehensive Gynecology . 4th ed. Mosby; 2001:878-880. Last reviewed March 2008 by Ganson Purcell Jr., MD, FACOG, FACPEPlease 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.
