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It is an excision of a cone-shaped sample of tissue from the mucous membrane of the cervix. Cervical conisation detects and treats abnormalities of the cervix. It is also referred to as cold knife cone biopsy or cone biopsy. The cervix is a cylindrical neck of tissue that connects the uterus and the vagina. It is about one inch across and is made of cartilage covered by smooth, moist tissue.
Types of cervical conisation
Cold knife conization (CKC): This type of cervical conisation uses a scalpel, electrosurgical loop or laser. It provides clean specimen margins for study. The laser energy produces dots that can be used to outline the exocervical margins accurately. It is associated with significant bleeding and in most cases requires general anesthesia. It also takes a longer time.
Loop electrosurgical excision procedure (LEEP): It is also known as large loop excision of the transformation zone (LLETZ) and is done in an outpatient center. The procedure is short, margins for histological evaluation are preserved and blood loss is minimal.
Combined conization: In this technique the procedure usually begins with a laser and ends with a cold knife technique.
Laser conization: This can either be destructive (by vaporization) or excisional.
Why a cervical conization is performed
If the results of a cervical biopsy find a precancerous condition in the cervix.
If a cervical smear test (Pap smear) shows abnormalities.
To remove precancerous cells.
To diagnose squamous or glandular intraepithelial lesions
To remove micro invasive carcinomas
To treat cervical intraepithelial neoplasia
Precautions
You should not eat or drink anything for about six to eight hours before the procedure. This is because you will be under general anesthesia.
The procedure
You will lie on a table with your feet in stirrups. You will be under general anesthesia as your vagina is held open with a speculum. The doctor will remove from the area with the abnormal cell, a cone-shaped piece of the cervix using a laser or scalpel. Flaps of tissue are stitched over the resulting wound to repair it. In other cases, heat or freezing is used to stop the bleeding while the wound is left open.
The removed tissue is examined for signs of cancer under a microscope. Other tests are usually enquired if there are cancer cells present. If the cells are precancerous, they can be destroyed with a laser.
Surgery will be performed to remove the cervix and uterus (hysterectomy) and also other treatments may be used.
The techniques used for diagnostic and therapeutic conization are almost identical. Individual needs are the determining factor as to adjusting the extent of excision.
Call your doctor for any of these symptoms:
A fever.
Heavy bleeding.
Increasing pelvic pain.
Yellowish or bad-smelling vaginal discharge
About Cervical Conisation
Key facts to plan your treatment: how long it takes, your hospital stay, anaesthesia, risks and recovery.
Recovery
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Risks
-Subsequent pregnancies may end up in preterm birth due to cervical incompetence.
-Significant bleeding when performed during pregnancy.
-Vaginal bleeding for about a week.
-Vaginal spotting or discharge for about three weeks
After care
You may need to stay overnight at the hospital. Cramps and discomfort may be experienced for a few days. You should avoid using tampons or douching and having vaginal sexual intercourse until a week after the procedure.
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