What is a Cold Knife Cone Biopsy Procedure?
Reproductive Health
Obie Editorial Team
A cone biopsy is used to remove abnormal cervical tissue for evaluation and treatment of certain conditions. During this procedure, a cone-shaped piece of tissue from the cervix is removed, as well as a small amount of normal tissue surrounding the cone biopsy itself to ensure that the margins surrounding the biopsy do not contain abnormal cells.
This procedure is done to both diagnose and treat certain conditions. A cone biopsy can detect pre-cancerous changes and also cervical cancer. Additionally, this procedure can treat CIN II or CIN III (moderate to severe cellular changes of the cervix) and stage 0 or IA1 cervical cancer.
Cone biopsies are done in an outpatient setting in which you will not be required to stay overnight in the hospital. There are various methods used during this procedure and may include the use of a scalpel, carbon dioxide laser, or a loop electrosurgical excision procedure referred to as a LEEP. During the procedure, you will be placed on your back and a speculum will be inserted into the vagina while your feet are placed into the footrests used during a normal GYN exam. Anesthesia, such as general anesthesia which will make you unconscious or local anesthesia which numbs the genitals will be used during the procedure.
As with any surgical procedure, there are risks associated with a cone biopsy and include bleeding, cervical scarring called stenosis which may cause infertility and an increased risk for future miscarriage or preterm delivery due to cervical incompetence.
Other risks include infection and/or the risk of damage to surrounding organs such as the bladder or rectum. Additionally, future Pap smear results may be more challenging to interpret following a cone procedure due to the healing process following surgery.
After a cone biopsy, you can expect to have some mild symptoms such as vaginal bleeding for about 1 week followed by spotting or brown /bloody/yellow vaginal discharge for up to 3 weeks. Tampons should not be used for approximately 4-6 weeks; for bleeding use pads instead. You should be able to return to your normal activities in about 1 week however sex should be avoided for 4-6 or so weeks and douching should be completely avoided.
It is recommended that you contact your healthcare provider if following your procedure you experience fever, heavy bleeding, pelvic pain, or foul-smelling vaginal discharge.
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