Definition

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.


Parts of the Body Involved

Uterine cervix


Reasons for Procedure

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.

Cervix With Precancerous Growth

Nucleus factsheet image

© 2008 Nucleus Medical Art, Inc.


Risk Factors for Complications During the Procedure

A slight risk for infection, excessive bleeding, and scarring of the cervix may occur with cervical conization.


What to Expect

Prior to Procedure

Do not eat or drink anything for 6-8 hours prior to the procedure.

Anesthesia

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

  • Local anesthetic—injected 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.

Description of the 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 Procedure

  • You 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 Complications

  • Infection of the cervical wound site
  • Heavy bleeding from the vagina
  • Premature delivery with future pregnancies

Average Hospital Stay

The procedure requires a several-hour stay in the hospital with a discharge the same day.

Postoperative Care

Activities 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.


Outcome

Conization completely removes the abnormal cervical tissue in 60%-90% of cases.


Call Your Doctor If Any of the Following Occurs

  • Heavy 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)