Biopsy - cone; Cervical conization; CKC; Cervical intraepithelial neoplasia - cone biopsy; CIN - cone biopsy; Precancerous changes of the cervix - cone biopsy; Cervical cancer - cone biopsy; Squamous intraepithelial lesion - cone biopsy; LSIL - cone biopsy; HSIL - cone biopsy; Low-grade cone biopsy; High-grade cone biopsy; Carcinoma in situ-cone biopsy; CIS - cone biopsy; ASCUS - cone biopsy; Atypical glandular cells - cone biopsy; AGUS - cone biopsy; Atypical squamous cells - cone biopsy; Pap smear - cone biopsy; HPV - cone biopsy; Human papilloma virus - cone biopsy; Cervix - cone biopsy; Colposcopy - cone biopsy
A cone biopsy (conization) is surgery to remove a sample of abnormal tissue from the cervix. The cervix is the lower part of the uterus (womb) that opens at the top of the vagina. Abnormal changes in the cells on the surface of the cervix is called cervical dysplasia.
This procedure is done in the hospital or in a surgery center. You will be placed under general anesthesia (asleep and pain-free), or you will be given medicines to help you relax and feel sleepy.
You will lie on a table and place your feet in stirrups to position your pelvis for exam. The health care provider will place an instrument (speculum) into your vagina to better see the cervix.
A small cone-shaped sample of tissue is removed from the cervix. The procedure may be performed using a wire loop heated by electrical current (LEEP procedure), a scalpel (cold knife biopsy), or a laser beam.
The sample is examined under a microscope for signs of cancer. This biopsy may also be a treatment if the provider removes all of the diseased tissue.
Most of the time, you will be able to go home the same day as the procedure.
You may be asked to not eat or drink for 6 to 8 hours before the test.
After the procedure, you may have some cramping or discomfort for about a week. For about 4 to 6 weeks avoid:
For 2 to 3 weeks after the procedure, you may have discharge that is:
Cone biopsy is done to detect cervical cancer or early changes that lead to cancer. A cone biopsy is done if a test called colposcopy cannot find the cause of an abnormal Pap smear.
Cone biopsy may also be used to treat:
A normal result means there are no precancerous or cancerous cells in the cervix.
Most often, abnormal results mean that there are precancerous or cancerous cells in the cervix. These changes are called cervical intraepithelial neoplasia (CIN). The changes are divided into 3 groups:
Abnormal results may also be due to cervical cancer.
Risks of cone biopsy include:
Cone biopsy may also make it hard for your provider to interpret abnormal Pap smear results in the future.
American College of Obstetricians and Gynecologists. Practice Bulletin No. 168: cervical cancer screening and prevention. Obstet Gynecol. 2016;128(4):e111-130. PMID: 27661651 www.ncbi.nlm.nih.gov/pubmed/27661651.
Baggish MS. Conization of the cervix. In: Baggish MS, Karram MM, eds. Atlas of Pelvic Anatomy and Gynecologic Surgery. 4th ed. Philadelphia, PA: Elsevier; 2016:chap 46.
Salcedo MP, Baker ES, Schmeler KM. Intraepithelial neoplasia of the lower genital tract (cervix, vagina, vulva): etiology, screening, diagnosis, management. In: Lobo RA, Gershenson DM, Lentz GM, Valea FA, eds. Comprehensive Gynecology. 7th ed. Philadelphia, PA: Elsevier; 2017:chap 28.BACK TO TOP
Review Date: 1/14/2018
Reviewed By: John D. Jacobson, MD, Professor of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda Center for Fertility, Loma Linda, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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