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| title | chunk | source | category | tags | date_saved | instance |
|---|---|---|---|---|---|---|
| Cervical conization | 2/2 | https://en.wikipedia.org/wiki/Cervical_conization | reference | science, encyclopedia | 2026-05-05T07:26:59.084677+00:00 | kb-cron |
The vagina is prepped using antimicrobial scrub or iodine. Draping is placed to maintain a sterile surgical field. Some physicians may choose to drain the bladder using a catheter. The speculum will be placed, and the cervix visualized. The tissue is then excised from the cervix. The tissue will include the transformation zone and will be shaped like a cone, as the procedure name suggests. The physician will ensure hemostasis has been achieved before removing the speculum and ending the procedure. Typically, the physician will place a suture at the 12 o'clock position of the excised tissue to serve as a reference point during histological examination. The main difference between cold knife conization and LEEP is the instrument used to excise the tissue. In a LEEP, a thin wire loop electrode is used to remove the cone-shaped surgical specimen. During a cold knife cone, a scalpel is used to excise the tissue. Both LEEP and cold knife cone have shown equal effectiveness, so the decision for which procedure is often based on the physician's comfort with each procedure or other clinical considerations. Cold knife cone is performed with a scalpel, and one advantage of this procedure is that the margins of the excised tissue will be free from thermal damage that would be present in the excised tissue from a LEEP. This can allow for more accurate analysis of the margin of the specimen. Contraindications to completing the procedure are cervicitis, pelvic inflammatory disease, or anticoagulation. Pregnancy is a relative contraindication, meaning that decisions of whether to perform the procedure in pregnant patients would be made on an individual basis. After treatment, screenings will continue. HPV screening is recommended 6 months after conization. Regular cervical cancer screening will resume as well, with the schedule of screening being determined by the type of abnormal cells that were present in the cervix. HPV vaccination may also be recommended as a part of the treatment plan to reduce the chances of abnormal cervical cells developing again.
== Complications == The most common complication of cervical conization is bleeding during the procedure or within a few weeks after the procedure. Infection after the procedure is possible but very rare. There is the possibility of cervical stenosis or cervical insufficiency. The data regarding the risk of preterm birth and low birth weight in future pregnancies is mixed; however, it is generally accepted that for patients desiring to carry future pregnancies, limiting the amount of cervical tissue that is excised is the best option to limit this risk. However, taking less tissue does produce an increased risk that the margins of the excised specimen will be positive, so the decision on how aggressively the excision is performed must be discussed between the patient and physician. Cervical conization effectively reduces the risk of cancer developing or spreading. The chances of cancer recurrence and premature birth depend on the type of conization. Cold knife conization is associated with 7% chance of the cancer recurring and a 16% chance of premature birth, laser conization comes with 6% cancer recurrence and 13% premature birth, and loop excision comes with a 10% recurrence and 11% premature birth.
== See also == Cervicectomy
== References ==