Gynecological Conization Surgery

Gynecological cone biopsy, also known as cervical cone biopsy, is a surgical method for treating various types of cervical diseases or other types of gynecological diseases. Before performing cervical conization, both the doctor and the patient need to prepare the patient, and also guard against the occurrence of various complications after the operation. Next, I will introduce you to some relevant knowledge about cervical conization!

1. Indications for surgery

1. If malignant cells are found multiple times in cervical smear cytology examination, colposcopy is normal, and cervical biopsy or segmental diagnostic curettage is negative, cervical conization should be performed for further diagnosis.

2. Cervical biopsy has confirmed high-grade cervical intraepithelial lesion (HSIL, including CINII-III, cervical carcinoma in situ), cervical adenocarcinoma in situ, and microinfiltration of cervical cancer (cervical cancer Ia1) under the microscope. In order to determine the scope of surgery, cervical conization can be performed first, and cervical tissue can be removed for further pathological examination to clarify the extent of the lesion and guide the selection of the scope of surgery.

3. Patients suspected of cervical adenocarcinoma, but cervical biopsy or endocervical curettage is negative.

4. For patients with chronic cervicitis who have cervical hypertrophy, hyperplasia, and ectropion and who have not responded well to conservative treatment, small-scale cervical conization can be performed.

2. Precautions for surgery

1. It is best to choose any day for the surgery between the end of menstruation and one week before the next menstruation.

2. Before the operation, routine blood tests and coagulation time should be performed, as well as tests for liver and kidney function, syphilis, HIV, hepatitis B two-to-half, hepatitis C, and an electrocardiogram is also required.

3. Preoperative examination of leucorrhea such as trichomonas fungi and pus cells should be performed to rule out vaginitis before surgery. Pay attention to the cleanliness of the vulva to avoid postoperative infection.

4. Avoid sexual intercourse within two months after surgery to prevent bleeding and wound infection.

5. If vaginal bleeding exceeds the amount of menstrual bleeding after the operation, you should go to the best local hospital immediately to stop the bleeding. Excessive vaginal bleeding may be life-threatening.

3. Surgical complications and treatment

1. Bleeding after surgery. Immediate bleeding after surgery is due to poor hemostasis during surgery. Secondary bleeding after surgery often occurs 5 to 12 days after surgery, and is more common in patients with deep resection of lesions and concurrent infections. Depending on the amount of bleeding, gauze compression, freezing, electrocautery, and re-suturing may be used, and occasionally hysterectomy may be required.

2. Uterine perforation or cervical perforation is extremely rare, but if it occurs, the uterus may need to be removed. 3. Pelvic infection after surgery requires treatment with antibiotics.

4. Cervical stenosis. The incidence rate is about 1 to 5%. According to literature reports, the incidence rate of cervical adhesion is related to patients over 50 years old and cone depth exceeding 2 cm. Patients may experience dysmenorrhea, menstrual retention, amenorrhea, or brown or black vaginal spotting during menstruation. Patients with cervical adhesions can use a cervical dilator to dilate the cervix.