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2023 Author: Alfred Shackley | [email protected]. Last modified: 2023-05-21 13:14
Conization of the cervix is a procedure that involves removing a portion of the mucous membrane of the cone-shaped part of the cervix. It is performed for diagnostic or therapeutic purposes in case of suspicion of erosion, dysplasia of the cervix, or the development of neoplasms in the uterus of any nature.
Conization of the cervix is not the most difficult and traumatic operation, therefore it takes place in a day hospital, if necessary, local anesthesia is used. There are various ways of performing this operation, the most preferred is radio wave conization. Complete healing occurs in 2-3 weeks. Correctly conducted conization of the cervix, as a rule, does not have any effect on future pregnancy and successful childbirth.
What is the procedure
By the very name of the operation, you can understand its essence: a cone-shaped part is removed from the cervix. In this case, a wide lower section of the mucous membrane captures the affected part of the vagina, and the narrow one is directed to the cervical canal. Conization can be shown in two cases: with pathologies of the uterus or for the purpose of their diagnosis.
The indications for conducting are as follows:
- dysplasia of the uterus 2-3 degrees;
- changes in epithelial tissue on the surface of the cervix, which also extend into the vagina.
After the affected areas are removed, the tissues must be examined. The goal is to confirm or deny malignant neoplasms of the cervix.
Contraindications to the procedure
Despite the fact that conization of the cervix is not considered difficult, there are cases when it is categorically not recommended to do it.
These include:
- confirmed uterine cancer;
- acute inflammatory and infectious diseases of the urinary-reproductive system in a woman or other organs of the small pelvis;
- pregnancy or lactation;
- any chronic diseases in the acute stage.
In this case, histologically confirmed malignant neoplasms are an absolute contraindication, while after elimination of the acute stage of diseases of the internal organs, conization can be carried out.
Operation methods
In modern gynecology, there are several methods of conization. Which one to choose is not only the patient's decision, guided by her financial capabilities and preferences. Some methods of conducting may be contraindicated for one reason or another, therefore it is reasonable to always listen to the doctor's recommendations.
Methods that are used today for conization:
- Classic surgical using a scalpel.
- Laser, using a laser scalpel.
- Electroconization.
- Loop electro excision.
- Radiowave conization.
Regardless of which method is chosen, it is recommended to carry out the operation in the first 3-5 days after the completion of menstrual bleeding. The duration of the operation is no more than a quarter of an hour. Local anesthesia is usually used - the patient is injected with anesthetic directly into the cervix. But general anesthesia is also possible.
Electroconization and removal of a portion of the mucous membrane with a surgical scalpel are outdated methods that are practically not used today. The main reason for refusing to carry out the operation in such ways is the formation of rough scars on the cervix after the intervention. This poses the greatest threat to nulliparous women, since seals on the cervix can disrupt the normal course of pregnancy and full-fledged labor.
Also, after conization of the cervix in the classical way using a scalpel, in more than 50% of cases, there are long and heavy bleeding. Laser conization is much safer and more convenient. But due to the rather high cost, this method is not the most popular, many patients simply cannot afford it.
The optimal choice is radio wave conization. To carry out the operation in this way, the devices "Surgitron" or "Fotek" are used. A radio wave is focused on the affected area, which guarantees the complete exclusion of trauma to neighboring healthy tissues. Bleeding after radio wave conization is also completely excluded.
Healing is much faster and smoother than after other methods. There are practically no cases of tissue infection, the female body recovers very quickly and within a few weeks after the operation, the patient can return to her usual full life.
But the most preferable today is the method of loop electroexcision. It is he who is practiced in the best and most modern clinics and is recommended to patients of any age, both for therapeutic and diagnostic purposes.
How is loop electro excision performed?
When carrying out an operation using this method, the removal of the affected tissue is carried out using a loop of thin wire, while a section of the cervical canal is captured. In this way, tissue can be removed without damaging and destroying it - this is very important if it is necessary to send the epithelium for histological examination afterwards.
Other advantages are that bleeding and pain are minimal with this technique, healing occurs very quickly, since damaged blood vessels and nerve endings undergo coagulation after the intervention. The scab is formed within a few hours, and after a few days the scab safely leaves without leaving any scars.
What happens after surgery
The operation is always performed using local or general anesthesia. But after the effect of the anesthetic is over, the woman may experience pain for several days, as during menstruation.
If the pain is very severe, then you can take any non-steroidal anti-inflammatory drugs in the appropriate dosage. For example, "Ibuprofen" or "Diclofenac".
There may be a discharge from the cervix that resembles menstruation - usually it is not very abundant, sometimes with an unpleasant odor.
The duration of the discharge is up to 21 days, this is considered a natural phenomenon that does not require specific treatment.
For 28 days after the operation (this is how long the full recovery period and tissue healing lasts):
- use hygienic tampons;
- visit a sauna or bath;
- do douching;
- lift weights;
- play sports or hard physical work;
- take a hot bath.
Any sexual intercourse is strictly contraindicated during the healing period. After the first menstruation has passed, there are no obstacles to pregnancy.
Possible complications after conization of the cervix
If the operation was performed in a trustworthy clinic by a qualified doctor, complications after it, as a rule, do not occur and healing takes place quite quickly. But sometimes they can occur, more often due to non-compliance with the doctor's prescriptions after the intervention.
These include:
- bleeding;
- wound infection;
- narrowing of the uterine canal;
- a decrease in the occluding ability of the cervix, which leads to miscarriage during pregnancy.
This does not mean that after conization of the cervix, the woman has no hope of pregnancy, the procedure does not affect the patient's reproductive abilities in any way. But scars on the cervix, if the method of electroconization was used, can make it difficult to open during childbirth.
Very rarely, cervical insufficiency develops after the procedure. At the same time, a woman cannot bear a child for a full term, pregnancy is difficult, since the cervix, as the fetus grows, opens prematurely and is not able to hold it - premature birth occurs.
Complications such as profuse, prolonged discharge and infections are practically not observed after the intervention today.
Conization of the cervix is a low-traumatic and in most cases completely safe operation, which is performed both for therapeutic and diagnostic purposes.