What you should know
A cervical cone biopsy is surgery to remove tissue from the cervix. The cervix is the small round opening at the bottom of the uterus (womb). The cervix connects the uterus to the top of the vagina (birth canal). You may need a cervical biopsy if cells that are not normal are found during a Pap test. But, a cone biopsy may also be used to treat early cancer and other problems. Sometimes instead of surgery to remove your uterus, cone biopsy can be done so you can still have babies. Following are some of the reasons you may need this surgery.
- Cervical dysplasia, which is disease of the tissue of the cervix
- Dysplasia involving the cervical canal
- Abnormal Pap smear, which is not explained by office biopsies
- Adenocarcinoma in situ
A biopsy that needs only a small amount of tissue may be done in the doctor's office. Since your caregiver needs to remove a larger, cone-shaped biopsy specimen (conization), you will need to go to the hospital. The procedure will be done in day surgery, and you will go home the same day of the surgery.
On the day of your surgery, please go to the Day Surgery Department at Brigham and Women's Hospital (75 Francis Street). Take the elevators to L1 and follow the signs for day surgery. You should arrive two hours in advance of your scheduled surgery. Upon arrival, check in with the receptionist. He or she will direct you to the pre-operative waiting area. You will remain in this waiting area until called for your surgery. Once you have been called for surgery, your family and friends will be directed to the family waiting area. This area provides a comfortable central location for family members to wait while surgery is underway.
Post anesthesia care unit
After surgery, you will be monitored closely. You will wake up in the recovery room where nurses will be checking your blood pressure and pulse frequently. Although you will feel like sleeping, occasionally you will be asked to cough and take deep breaths to keep your lungs clear. You may be receiving oxygen by facemask. If you feel cool, the nurse will give you extra blankets.
The nurses want to make you as comfortable as possible, so let them know how you are feeling. You will still have an intravenous (IV) tube in your arm or hand. If it feels uncomfortable, please tell your nurse. It will be removed before leaving the hospital. If you wish to know about any equipment or procedures, the staff will be happy to explain it to you. Once you have sufficiently recovered from surgery, you will be discharged.
Recovery after surgery
After surgery, you may feel weak and tired from the anesthesia you received during the procedure. It may take a couple of days for the tired feeling to go away. You should continue to take deep breaths and cough every 3-4 hours while awake for the first 24 hours after surgery. Deep breathing opens the tubes going to your lungs and helps to clear the lungs of sputum (spit).
You may experience some abdominal cramping for 24-36 hours following the procedure. A prescribed pain medicine, or extra strength Tylenol, may be taken. If you are having persistent/severe abdominal or vaginal pain, please call your caregiver.
You will experience some bloody discharge. It should not be more than a light period initially. You may continue to have staining for 12-14 days. If you are experiencing heavy vaginal bleeding or clotting requiring you to change a pad an hour, you need to call your physician right away. During the procedure, packing may be used to stop bleeding. It is a natural product that may be absorbed or it may fall out. It may look black or bloody, which is normal. Your physician will tell you if packing was used.
- Nothing in the vagina for four weeks. Avoid vaginal douching, sex and tampons for four weeks, as they increase your risk for bleeding and/or infection.
- You may drive unless taking medication that makes you drowsy.
- You may return to work in 2-3 days.
- Avoid any heavy lifting or aerobic type exercises for two weeks.
Reasons to call us
- Temperature over 100.5 F;
- Yellow/green foul smelling vaginal discharge;
- Persistent/severe abdominal or vaginal pain;
- Vaginal bleeding or clotting more than a pad an hour;
Telephone numbers to call during office hours (8 a.m.-4:30 p.m.)
Dana Farber: 617-632-3669
Brigham and Women's: 617-732-8844
If it is after 4:30 p.m. or a weekend, please call the page operator at 617-732-6660 and have the gynecologic oncology fellow on call paged.
The final pathology report is usually sent out in 5-7 business days. To inquire about results, please call 617-732-8844.
You will need to return in 3-4 months for a follow-up pap smear. Call 617-632-3669 (at Dana-Farber) or 617-732-8844 (at Brigham and Women's) a few days after the procedure to schedule a post-operative appointment.