Cervical Cone Biopsy
Your cervix is the opening between your vaginal vault and your uterus, which is also called your womb. Your cervix can open and close to protect your uterus. If your doctor suspects an abnormal condition, including cancer, in your cervix, collecting a biopsy or tissue sample may be the next step. But normal biopsy procedures yield a small number of cells. When a larger sample is required, a cervical cone biopsy — also called conization — can help.
A cervical cone biopsy is a surgical procedure that extracts a cone or wedge-shaped piece of tissue from your cervix. The extracted tissue is sent to the lab, where it’s checked under a microscope for analysis. This procedure captures a relatively large tissue sample. If your OBGYN only needs a small sample, a LEEP suffices. The size of the tissue sample required is a deciding factor when considering cervical cone biopsy vs LEEP.
Reasons for a Cervical Cone Biopsy
The procedure captures a tissue sample from your cervix. The reasons your doctor might perform this operation include:
- Your Pap smear test results were abnormal and can’t be diagnosed with a smaller biopsy.
- Your OBGYN suspects you have dysplasia (or enlargement) of the cervix or cervical canal.
- Your doctor has confirmed early stages of cancer, such as adenocarcinoma in situ, on your cervix and can remove the cancerous cells to save your uterus.
- You have a human papillomavirus (HPV) infection on your cervix and need an HPV biopsy.
If you have cervical cancer, the recommended treatment is a total hysterectomy. But if the cancer is caught early enough, your doctor can save your uterus by excising the cancer cells from your cervix using this procedure. In this case, the cervical cone biopsy procedure is a treatment, not a diagnostic tool.
Procedure for a Cervical Cone Biopsy
You have to be unconscious for this procedure, so you’ll likely receive general anesthesia. Even though a cervical cone biopsy is an outpatient surgery, you’ll need someone else to drive you home after you recover enough to be discharged.
After you’re under anesthesia, your gynecologist inserts a speculum to get access to your cervix. Depending on where on your cervix the abnormal or cancerous cells are, the doctor may have to mechanically or chemically open your cervix.
Then a wedge or cone-shaped section of tissue is cut from your cervix. Your OBGYN uses a surgical knife or a laser knife to make the cut. Once the tissue has been extracted, your doctor stops the bleeding with a natural product that packs the wound, helping it heal. The biopsy is sent to the lab for analysis. The whole operation takes less than an hour, usually between 30 and 45 minutes.
Risks from the Procedure
Like any surgery, the cervical cone biopsy procedure carries some risks. The procedure is safe, so complications are rare, but you could suffer:
- An allergic reaction to the anesthesia
- Excessive bleeding
- Scarring of your cervix
- Blood clots in your legs
- Chest pain and shortness of breath
Your future Pap smear test results may be trickier to read. There are many factors that contribute to this issue. Additionally, depending how much of your cervix is removed, you may find pregnancy after cone biopsy difficult to achieve. Even if you do get pregnant, you’re at a greater risk for a miscarriage or premature baby.
Talk to your gynecologist about your concerns. Also, keep in mind that most women recover from a cervical cone biopsy without any side effects.
Recovering from Cervical Cone Biopsy
After surgery, you’ll have some time to recover under the watchful eyes of recovery room nurses. Once you’re drinking on your own, your IV is disconnected. If you have a catheter in place, it will be removed before you leave. When you’re conscious and well enough, you’ll be discharged so your friend or family member can drive you home, where you’ll spend the rest of your recovery.
The anesthesia may make you weak and tired that first day. You’ll feel some post-cervical biopsy pain and cramping for two to three days after your procedure. Your doctor gives you a prescription for pain medication, and as you wean yourself off of that, you can take acetaminophen (such as extra strength Tylenol) as needed.
You need to wear a pad for the next two weeks, as you’ll have some vaginal discharge. It may be bloody, and it may contain dark spots. This is from the natural packing used to stop your bleeding after the surgery.
You should get out of bed to walk every day. It’s also recommended that you take deep breaths and cough every three hours while you’re awake, at least for the first day, to strengthen your lungs.
Everyone heals at a different pace. Your recovery can depend on your physical condition and age, as well as the severity of the procedure. Follow your doctor’s instructions and:
- Do not have sex after cervical biopsy for four full weeks.
- Do not use tampons or douche for four weeks.
- Do not do any heavy lifting or strenuous exercise for two weeks.
- You can return to work after two or three days, depending on your job and how you feel.
- You can drive once you stop taking prescription pain medicine that makes you drowsy.
Your recovery should progress every day. Normally, you only need to return to your OBGYN for a follow-up visit, but call immediately if you experience:
- Worsening and severe pain in your vagina
- A fever with a temperature over 100.5 degrees Fahrenheit
- Vaginal bleeding that forces you to change pads more frequently than once an hour
- A foul-smelling vaginal discharge that may be green or yellow
Results from a Cervical Cone Biopsy
The cone-shaped tissue sample taken from your cervix is sent to the lab for analysis. If cancer is found, you may need further, more invasive tests. It’s possible that you may need a total hysterectomy, which removes your uterus and cervix. It’s also possible that the tests will come back cancer-free.
Your procedure may have removed the precancerous or cancerous cells from your cervix, allowing healthy cells to grow back. Every case is different. Talk to your OBGYN about your concerns before you agree to a cervical cone biopsy.
All symptoms/diagnoses should always be evaluated with a thorough consultation and examination by your gynecologist for an accurate diagnosis and treatment plan to exclude any underlying serious condition. The cervical cone biopsy procedure, indications, options, risks/benefits should always be discussed with your gynecologist.
Important Reminder: This information is only intended to provide guidance, not a definitive medical advice. Please consult ob/gyn doctor about your specific condition. Only a trained, experienced board certified gynecologist can determine an accurate diagnosis and proper treatment.
Do you have questions about Cervical Cone Biopsy procedure? Would like to schedule an appointment with nationally recognized NYC OBGYN specialist, Dr. Pedram Bral of Manhattan Women’s Health and Wellness, please contact our office for OBGYN consultation.
Dr. Pedram Bral, Gynecologist (Gynecologist NYC, Midtown)
New York, NY10010
(Between Madison Ave & Park Ave)
☎ (212) 533-4575