Surgery Overview

A cone biopsy (conization) is a type of surgery. It removes a cone-shaped piece of tissue from the cervix. The cervix is the lower part of your uterus. It opens into your vagina.

There are a few ways the doctor can remove the tissue. One way is to use a surgical knife called a scalpel. Another way is to use a thin wire loop that's charged with electricity. Or the doctor can use a laser.

You may be asleep during the surgery. But it is usually done while you are awake. Either way, you will not feel pain. The doctor removes the tissue through the vagina. The surgery won't leave a scar on the outside of your body.

After surgery, another doctor will look at the tissue under a microscope. The doctor will check it for abnormal cells.

Most people go home 1 to 4 hours after surgery. You will probably be able to return to your normal routine in 1 or 2 days. But be sure to wait to have sex until your doctor says it's okay.

What To Expect

Most people can return to their normal activity level in 1 week.

If you have a cone biopsy, you need regular follow-up Pap tests and colposcopic examinations. A Pap test should be repeated every 4 to 6 months or as recommended by your doctor. After several Pap test results are normal, you and your doctor can decide how often to schedule future Pap tests.

Some vaginal bleeding is normal for up to 1 week. Some vaginal spotting or discharge (blood or dark brown) may occur for about 3 weeks.

• You will have some light vaginal bleeding or discharge. This usually lasts for up to a week or two after surgery. Wear sanitary pads if needed. Do not douche or use tampons.
• Do not have sex or place anything in your vagina for 4 to 6 weeks after surgery, or until your doctor tells you it is okay.
• If you have cramps after your surgery, try placing a hot water bottle or heating pad on your lower belly.

Why It Is Done

A cone biopsy may be done after a cervical cancer screening test found a problem. It may be done:

• To remove and examine the abnormal tissue.
• To diagnose the cause of the abnormal cell changes and remove the abnormal tissue at the same time.
• To determine the extent, depth, and severity of the cancerous tissue.

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How Well It Works

The cone biopsy may remove all of the abnormal tissue. If this happens, you won't need more treatment. But if some abnormal cells are left in the cervix after the biopsy, more tissue may need to be removed. If follow-up tests show normal cells, then no further treatment will be needed. If abnormal cells remain, you and your doctor may discuss other treatments, such as removal of the uterus (hysterectomy).

The cone biopsy may show cancer that has grown deep into the cervical tissue (cervical cancer). Further treatment, such as surgery, radiation, or chemotherapy, will be recommended.

Risks

A cone biopsy is a surgical treatment with some risks.

• A few people may have serious bleeding that requires further treatment.
• Narrowing of the cervix (cervical stenosis) that causes infertility may occur (rare).
• Inability of the cervix to stay closed during pregnancy (incompetent cervix) may occur. Having a cone biopsy may increase the risk of miscarriage or preterm delivery.