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

Conization of the cervix with a laser is a procedure in which the doctor uses a laser beam to remove tissues from the cervix that may be precancerous or cancerous.

When is it used?

This procedure is done for the following reasons:

• To treat severe precancerous cells on the cervix.
• To further diagnose cancer.
• To try to answer questions not answered by a colposcopy. Your doctor may not have been able to see all the problem tissue with the colposcope.
• To better understand the results of a Pap smear and colposcopy.

Examples of alternatives include:

• loop electrosurgical excision procedure (LEEP)
• surgical conization of the cervix
• removal of the whole uterus and cervix
• other forms of cancer treatment if you have cancer.

You should ask your doctor about these choices.

How do I prepare for 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 particular preparation is needed for local anesthesia or IV sedation. 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?

A paracervical block (local anesthesia) may be used. A local anesthetic numbs part of your body while you remain awake. It should keep you from feeling pain during the operation. IV sedation or a general anesthesia may be given instead of a paracervical block. 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 bathes the cervix with a solution to highlight the problem areas on the cervix. Then a laser is used to cut around the opening in the cervix and remove a cylinder-shaped piece of tissue with the opening to the uterus running through the center. The doctor tries to make the cylinder large enough to remove all of the abnormal tissue.

What happens after the procedure?

After leaving the hospital or outpatient surgery center, avoid all heavy activity the rest of the day. Often you will be given an antibiotic cream to put in the vagina to lower the chance of infection. 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?

• The abnormal tissue in the cervix lining is removed.
• It may help the doctor make a better diagnosis.

What are the risks associated with this procedure?

• There are 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.
• IV sedation may cause you to have an allergic reaction to the sedative, respiratory arrest, lowered blood pressure, heart rhythm disturbance, or a bad reaction when the sedative is combined with other medications. These risks depend on the type, amount, and rate of sedation.
• More surgery may be necessary.
• The laser may cut too deeply and injure the vagina.
• If the doctor removes a lot of tissue, you may have trouble holding a pregnancy to its full term.
• If the doctor removes too little tissue, some cancer or precancer cells may remain and the cancer may come back.
• There is risk of 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 bleeding again.
• You are in a lot of pain.
• You develop 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.