A cold knife cone biopsy (conization) is a procedure to get a sample of abnormal tissue from the cervix for further examination.
See also: Colposcopy-directed biopsy
Cone biopsy; Biopsy - cone; Cervical conization
This is a surgical procedure. It is done in the hospital while you are either sedated through an IV or under general anesthesia.
You will lie on a table and place your feet in stirrups to position your pelvis for examination. The doctor will insert an instrument (speculum) into your vagina to open the vaginal walls and examine the cervix.
A small cone-shaped sample of tissue is removed from the cervix and examined under a microscope for any signs of cancer. This biopsy may also be the treatment if the doctor removes all of the diseased tissue.
As with any procedure that is done under anesthesia, you will probably need to fast for 6 - 8 hours. You must sign an informed consent form. The procedure is done on the same day (outpatient) and a hospital stay is usually not needed.
After the procedure, you may have some cramping or discomfort for a week or so. For about 4 - 6 weeks avoid:
For 2 - 3 weeks after the procedure, you may have discharge that is:
A cold knife biopsy may be done if a cervical biopsy using colposcopy cannot find the cause of an abnormal Pap smear.
Conization may also be used to treat moderate to severe biopsy results (CIN II or III). Very early stage cervical cancer (stage 0 or IA1) may be treated with conization. Abnormal cells from the cervical canal, including adenocarcinoma in situ, may be diagnosed, and sometimes treated with cone biopsy.
There are no precancerous or cancerous cells in the cervix.
Most often, abnormal results mean that there is an area of precancerous or cancerous cells.
Noller KL. Intraepithelial neoplasia of the lower genital tract (cervix, vulva): Etiology, screening, diagnostic techniques, management. In: Katz VL, Lentz GM, Lobo RA, Gershenson DM, eds. Comprehensive Gynecology. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 28.
American College of Obstetricians and Gynecologists. ACOG Practice Bulletin No. 99: Management of abnormal cervical cytology and histology. Obstet Gynecol. 2008;112:1419-1444.