McKesson Clinical Reference Systems: Women's Health Advisor 2002.2
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What is operative conization of the cervix?

Operative conization of the cervix is an operation to remove cancerous or precancerous cells from the cervix. The cervix is the lower, cone-shaped part of the uterus. The uterus is a muscular organ at the top of the vagina where menstruation begins and babies grow.

When is it used?

This procedure is performed if a Pap smear shows a lesion that could be cancerous or precancerous.

Examples of alternatives are:

• conization with a laser
• removal of the entire uterus
• other forms of cancer treatment
• to choose not to have treatment, recognizing the risks of your condition.

You should ask your doctor about these choices.

How do I prepare for operative conization of the cervix?

Plan for your care and recovery after the operation, especially if you are to have general anesthesia. Allow for time to rest and try to find other people to help you with your day-to-day duties.

Follow instructions provided by your doctor. No special preparation is needed for local anesthesia. If you are to have general anesthesia, eat a light meal, such as soup or salad, the night before the procedure. Do not eat or drink anything after midnight and the morning before the procedure. Do not even drink coffee, tea, or water.

What happens during the procedure?

You are given a local or general anesthetic. A local anesthetic numbs part of your body while you remain awake. It should keep you from feeling pain during the operation. A general anesthetic relaxes your muscles, makes you feel as if you are in a deep sleep, and prevents you from feeling pain.

The doctor will bathe the cervix with a solution and put two stitches in the cervix to help control bleeding. The doctor will then cut around the opening in the cervix and remove a cone-shaped piece of tissue with the opening to the uterus running through the center. He or she will try to make the cone large enough to remove all of the abnormal tissue.

What happens after the procedure?

You may go home later in the day or you may stay overnight in the hospital. This will depend on how much tissue was removed and how fast you recover from the anesthetic.

Avoid stressing your cervix and do not have intercourse for the next month. Ask the doctor what other steps you should take and when you should come back for a checkup.

What are the benefits of this procedure?

You may decrease the risk of developing cervical cancer.

What are the risks associated with this procedure?

• There are some risks when you have general anesthesia. Discuss these risks with your doctor.
• A local anesthetic may not numb the area quite enough and you may feel some minor discomfort. Also, in rare cases, you may have an allergic reaction to the drug used in this type of anesthesia. Local anesthesia is considered safer than general anesthesia.
• You may need more surgery.
• The cervix may start to bleed several days after the operation and need more surgery.
• If the doctor removes a lot of tissue, you may have trouble holding a pregnancy to its full term.
• If the doctor does not remove enough tissue, some cancer or precancer cells may remain.
• You may develop an infection or bleeding.

You should ask your doctor how these risks apply to you.

When should I call the doctor?

Call the doctor immediately if:

• You start to bleed again.
• You are in a lot of pain.
• You have a fever.

Call the doctor during office hours if:

• You have questions about the procedure or its result.
• You want to make another appointment.

This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.