A cone biopsy removes a cone-shaped piece of tissue from the cervix. The cone is formed by removing the outer part of the cervix closest to the vagina and part of the endocervical canal. A cone biopsy may be used to treat precancerous conditions of the cervix and carcinoma in situ (non-invasive or pre-invasive disease) in the cervix.
A cone biopsy is also called cervical conization.
Why a cone biopsy is done
A cone biopsy may be done to:
- follow-up Pap tests that are consistently abnormal
- help diagnose precancerous changes and carcinoma in situ (non-invasive or pre-invasive disease) in the cervix
- diagnose invasive cervical cancer (cancer that is growing into surrounding tissue or has spread beyond the cervix)
- treat precancerous changes and carcinoma in situ in the cervix
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How a cone biopsy is done
Depending on the method used, a cone biopsy may be done in a doctor’s office, colposcopy clinic or hospital on an outpatient basis. Local or general anesthetic will be given. All cone biopsies are done during colposcopy, so the doctor can view the area and guide the tools used to perform the cone biopsy. A woman may have stitches to close the wound after a cone biopsy.
There are 3 ways to do a cone biopsy.
- Loop electrosurgical excision procedure (LEEP) uses a thin wire loop heated by an electrical current to remove the cervical tissue.
- Cold-knife excision uses a surgical scalpel to remove the cervical tissue.
- Laser excision uses a laser (an intense, narrow beam of light) to remove the cervical tissue.
After a cone biopsy, a woman will be told to:
- avoid having sexual intercourse
- not insert anything into the vagina (such as tampons or a vaginal douche) for several weeks after the procedure
- report any unusual pain in the pelvis, heavy bleeding or signs of infection (foul-smelling or yellowish discharge) to the doctor
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Potential side effects
Side effects can occur with any type of treatment, but not everyone has them or experiences them in the same way. Short-term side effects can happen during, immediately after or a few weeks after a cone biopsy. They are usually temporary. These may include:
- mild cramping and discomfort
- bleeding or spotting
- dark-brown discharge
Some women may be at risk of having a premature birth if they get pregnant after having a cone biopsy.
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What the results mean
If done for diagnostic reasons, the pathology report indicates the characteristics and type of cells present and if cells are normal, non-cancerous or cancerous.
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What happens if a change or abnormality is found
The doctor will decide whether further tests, procedures, follow-up care or additional treatment is needed.
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