A cold knife cone biopsy (conization) is a procedure to get a sample of abnormal tissue from the cervix for further examination.

See also: Colposcopy-directed biopsy

Before colposcopy was commonly used, cold knife cone biopsy was the standard next step to diagnose the cause of worrisome Pap smear results. Now, colposcopy is almost always the first step.

A cold knife biopsy may be done if a cervical biopsy using colposcopy cannot find the cause of an abnormal Pap smear.

Conization may also be used to treat moderate to severe biopsy results (CIN II or III). Very early stage cervical cancer (stage 0 or IA1) may be treated with conization. Abnormal cells from the cervical canal, including adenocarcinoma in situ, may be diagnosed, and sometimes treated with cone biopsy.

This is a surgical procedure. It is done in the hospital while you are either sedated through an IV or under general anesthesia.

You will lie on a table and place your feet in stirrups to position your pelvis for examination. The doctor will insert an instrument (speculum) into your vagina to open the vaginal walls and examine the cervix.

A small cone-shaped sample of tissue is removed from the cervix and examined under a microscope for any signs of cancer. This biopsy may also be the treatment if the doctor removes all of the diseased tissue.

As with any procedure that is done under anesthesia, you will probably need to fast for 6 - 8 hours. You must sign an informed consent form. The procedure is done on the same day (outpatient) and a hospital stay is usually not needed.

After the procedure, you may have some cramping or discomfort for a week or so. For about 4 - 6 weeks avoid:

• Douching (you should never do this in any case)
• Sexual intercourse
• Using tampons

For 2 - 3 weeks after the procedure, you may have discharge that is:

• Bloody
• Heavy
• Yellow-colored