Conization (1): What is it?

By Dr. Claude Allouche, Gynecologist
Ahuza Clinic, Raanana
📞 058 726 02 64

What is conization?

Conization is a surgical procedure to remove part of the cervix. The removed tissue is conical in shape (1–2 cm in diameter and approximately 1.5 cm in height), giving the procedure its name.

When is it recommended?

It is performed when abnormalities, known as cervical dysplasia, are detected during a Pap smear and biopsy.
The procedure is typically preceded by a colposcopy, which uses dyes to locate lesions and allows for targeted biopsies.

Purpose of the procedure:

  • Diagnostic: To confirm the exact nature and extent of the lesions.
  • Therapeutic: To treat dysplasia by removing the entire lesion.

What happens to the removed tissue?

The surgical specimen is sent to a pathology lab to confirm the lesion’s nature and ensure its complete removal.

How is the procedure performed?

  • Location: The procedure is performed in an operating room through the vaginal route.
  • Anesthesia: Local, regional, or general anesthesia is used. Some specialists perform it under local anesthesia.
  • Duration: It lasts between 10 and 30 minutes.
  • Comfort: It is a quick and straightforward procedure, with minimal postoperative discomfort since the cervix has few nerve endings.
  • Outpatient setting: Most patients are discharged the same day.

Potential Complications

1. Short-term risks:

  • Hemorrhage: This is the primary risk in the hours following surgery and may rarely require a return to the operating room.
  • Anesthesia-related risks.

2. Medium- and long-term risks:

  • Delayed hemorrhage: This can occur up to 15 days post-procedure due to scab detachment.
  • Cervical stenosis: Narrowing of the cervical canal after healing, which can cause:
    • Menstrual flow obstruction.
    • Difficulty monitoring the cervix via Pap smears or colposcopy.
    • Challenges with cervical dilation during childbirth (rare).
  • Preterm birth risk: There is a slightly increased risk, though this is relatively rare after a simple conization. Routine cervical cerclage is not necessary for asymptomatic patients.

Conization (2): What happens next?

Post-Conization Guidelines

Returning Home:

Since conization is usually performed on an outpatient basis, patients return home the same day.

Advice for recovery:

  • Limit physical activity for 24 hours.
  • Eat light meals.
  • Avoid alcohol.
  • Avoid being alone the night after your procedure (especially if performed under general anesthesia).

The First Few Days:

  • Avoid baths, sexual intercourse, and tampons for the first 15 days.
  • Showers are permitted.
  • Avoid sports activities and heavy lifting for three weeks.

Resuming Activities:

You can return to work the day after your procedure.

Follow-Up Care

  • A follow-up appointment is scheduled one month after the procedure to review pathology results.
  • Depending on your initial condition, a Pap smear will be conducted 3–6 months after the procedure and regularly every 6–12 months for the next two years.

Warning Signs to Watch For

Contact your doctor immediately if you experience:

  • Heavy bleeding (more than your usual menstrual flow).
  • Fever above 38°C (100.4°F).
  • Pain.

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