Cervical Conization

Article

23. 04. 2018 Gynecology

Cervical conization is a minor gynecological procedure which involves the removal of a part of the cervix. The removed part often has the shape of a cone, hence the name of the procedure. The procedure is carried out on women who have been diagnosed with precancerous changes on the uterine cervix or other changes that indicate abnormal cytological or colposcopic findings. 

 

Prior to the procedure

You should receive all important information concerning the planned procedure from your doctor. 

You should however inform your doctor with the following information:

  • You suffer from allergies
  • Any long-term medication you are using
  • Any coagulation disorders you may have (bleeding disorders)
  • Any surgeries you have undergone
  • Any other disease that you are suffering from

Prior to the procedure itself, you can eat dinner. However, from midnight onwards, you should not drink or eat anymore. If you are using long-term medication, ask your doctor if you should take them on the day of the procedure.  

 

During the procedure

The surgical procedure is most commonly carried out under short general anesthesia. During the anesthesia, your veins will be supplied with medication to ensure that you are asleep and relaxed throughout it being carried out. Prior to the procedure, you will be placed in the so-called gynecology position where you lay down your back with your feet angled and supported. 

Only once the anesthetic is fully active and you are asleep will the doctor disinfect the vagina and insert a speculum into it. The doctor can, but does not have to, apply an injection of a substance that causes temporary contraction of the blood vessels which can have a positive effect on the progress of the surgical procedure. Sometimes, for the very same reasons, temporary sutures are made on the sides of the cervix. The doctor then removes the affected sections which are diseased using loop electrical excision, an electric needle or an ordinary scalpel. As part of the procedure, the doctor scrapes a section of the mucosa from the cervical canal (endocervical curettage). All collected tissue is then sent to the laboratory for examination. If the facility where the procedure is carried out has a laser at disposal, it can also be used to carry it out. The procedure usually last between 15 to 30 minutes and overnight hospitalization is generally not necessary.


After the procedure

After you wake up from the procure, you will find yourself in the resting room where you will remain for 4 more hours. Only once you are fully conscious and stable, you will be released from the clinic. For the journey home, please make sure you have someone to take you. You should most definitely not drive yourself. Overnight hospitalization, considering all went smoothly is unlikely. In the first hours following surgery, you can feel nauseous or like vomiting. In such cases, you will be given medication to make you feel better. In case you were intubated during the procedure (you had a flexible plastic tube applied to allow you to breathe), you can experience pain and scratching in your throat. This uncomfortable feeling can be alleviated with any menthol lozenges. Following the surgery, you can also experience lower abdominal pain and bleeding. This can persist, disappear and reappear again (or even worsen) 7-10 days following the procedure. Generally, this is when the scab is being expelled by the body. This leaves behind sensitive tissue and bleeding therefore does not generally constitute a warning signal of healing progressing badly. 

 

What to ensure following the procedure

  • You should not drive a car for 24 hours after the procedure.
  • For the first 4 days following the procedure, measure your body temperature 2x per day and note down the measurements in case you would need to urgently visit a doctor.
  • Avoid any heavy physical strain for a period of 1 week following the procedure. For the same amount of time, avoid lifting heavy objects (5 Kg and more).
  • For a period of 2 weeks, only use the shower instead of baths, or accordingly based on the recommendation by the doctor responsible for treating you. For the same time (at minimum), do not swim, use tampons or flush the vagina. 
  • You can have sexual intercourse 4-6 weeks after the procure.

 

Complications

Complications following this procedure are relatively rare. They can include post-surgery inflammation at the wound, early and belated bleeding from the wound and in exceptional cases damage to the surrounding organs (urinary bladder, uterus and the intestines) arising throughout the procedure. 

 

When should you call an emergency?

  • When you suffer from pain that is not getting better even after using painkillers or you experience sudden and escalating pains.
  • When you identify a smelly discharge from the vagina.
  • When you experience a rash.
  • When you start bleeding more than you do during menstruation or you are bleeding with blood clots.
  • When you experience a fever.
  • When you are experiencing chest pains or have difficulty breathing. 
  • When your head is spinning and you are fainting. 
  • When you identify blood in stool or urine.

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