What is conization of the cervix, how the operation is going on are quite relevant issues today. This is a surgical procedure aimed at cone-shaped removal of clusters of mutated cells. After that, the deleted fragment goes through histology to identify or exclude oncology.
Who is prescribed cervical conization? How is the operation?
The name of the procedure comes from the word "cone" and means the cone cutting of a single piece of tissue. This form of section is considered the most facilitated type of surgical intervention, given the structure of the organ, the placement of blood vessels. In addition, scars and deformations do not form on the surface of the neck.
Conization of the cervix is prescribed when a woman reveals dysplasia of the epithelium, erosion, polyps, miamatous and endometriotic nodes, cysts, large scars (consequences of childbirth), ectropion or eversion of the mucous membrane, the initial stage of cancer.
Before manipulation, the patient undergoes a thorough examination and the necessary treatment for the detection of inflammatory processes in the genitals. To do this, the doctor prescribes tests:
- general blood and urine tests;
- blood biochemistry;
- tests for hepatitis B and C, HIV infection and syphilis (PB);
- smear to detect mutated cells and microflora;
- detection of infectious agents (PCR diagnostics);
- coloscopy (internal examination of an organ through a coloscopy).
A month before surgery, the patient is recommended to exclude intimate relationships and observe personal hygiene.
When such a procedure is prescribed, many women have the first questions: what is conization of the cervix? How is the operation? Under anesthesia or not?
In fact, this procedure is carried out using local anesthesia, usually a solution of lidocaine and adrenaline at a concentration of 1%. If the patient is allergic to local anesthetics, then a short intravenous anesthesia is used. Therefore, the operation is considered to be painless. The best time for the operation is considered to be the first week after the completion of menstrual flow, since this practically eliminates pregnancy, and there is a rather long time for healing the wound after surgery.
Conization Technique:
- Insertion of a plastic mirror into the vagina.
- Processing the neck with iodine solution to mark the boundaries of the affected tissues.
- Excision of the affected area.
- Extraction of the cut fragment and its further investigation.
- Cauterization of bleeding areas.
Typically, the manipulation takes place within 15 minutes.
Contraindications for conization
Conization of the cervix is not carried out if there are inflammatory processes in the genitals. In such cases, the operation is postponed to a later period in order to remove inflammatory diseases.
The procedure is excluded if oncology of the cervix in the third or fourth stage was detected during the examination. In this case, there is a risk of the spread of cancer cells to neighboring organs. As a result, damage to the vagina, bladder, and rectum can occur. The reason for this development of events may not be the mistake of the operating doctor, but the nature and deceit of the tumor itself, which seeks to take root in all parts of the body.
If such a tumor is detected, removal of the entire organ is indicated.
Rehabilitation
Also, many have questions about the rehabilitation phase after cervical conization. How does healing go?
A full recovery takes several months. After the procedure, women ascertain a brownish, bloody secret from the genital tract, which has a specific smell. This may continue for a month. In addition, pain that is aching, pulling, or cramping can be disturbing. Do not be scared if the first menstruation is accompanied by more abundant discharge with the presence of clots - this is the norm.
To exclude discomfort after manipulation, it is recommended:
- taking anti-inflammatory and analgesic drugs;
- abstinence from sexual intimacy until the complete cessation of sucrose secretions (2-3 weeks);
- exclude the introduction of tampons, suppositories and ointments into the vagina, douching;
- abstinence from taking a bath, visiting the pool and sauna;
- limit physical activity;
- not be in conditions of elevated temperatures (beaches, tanning salons, near furnaces and ovens).
Two weeks after conization, an examination is required to monitor the healing process, as well as to identify and prevent possible consequences.
Three to four months later, coloscopy and cytological examination of the genitals are performed. At this point, the healing process should be completed.
Possible consequences of manipulation
Current surgical methods of conization minimize the development of complications. However, they cannot be completely excluded:
- The development of bleeding.
- The penetration of infection.
- Stenosis of the cervical canal (narrowing).
- Violation of the locking ability of the cervix, which can lead to miscarriage.
- Change in the properties of mucous secretions from the cervical canal.
- Decreased fertility.
The occurrence of scars after surgery is rare, because the electrocoagulation method is not used.
Methods of the procedure
Modern medical practice involves uterine conization in several ways:
- Laser. It is the most expensive, but also the most high-tech.
- Radio wave. The method consists in exposing the affected area to electric shock.
- Petlev. The method has a minimal risk of complications and an acceptable cost.
- With a knife. Today it is rare, because it has a high probability of developing negative consequences.
Today the most effective is laser conization, which is considered the least traumatic. However, conization using the loop method is the most common, because it ideally combines an affordable price with high quality, as evidenced by expert reviews.
Laser conization method
This method is the most expensive, and therefore questions arise: what is laser conization of the cervix? How is the operation going and what are its advantages?
The procedure is performed under short-term general anesthesia using a carbon dioxide laser, which imitates the scalpel technique. Before the operation, the surgeon exposes the cervix and treats the external genitalia with antiseptic solutions. Under the continuous influence of the laser beam, the affected area is outlined in the form of a cone, and a small fragment of healthy tissue (1-2 mm) is also captured. At the same time, cauterization of the edges of the wound.
Advantages of the method:
- reduction of pain to a minimum during and after surgery;
- prevention of postoperative puffiness;
- reduction of spotting during the healing period;
- the laser destroys microorganisms, therefore, the risk of infection of the surgical field is reduced;
- tissue scarring after the procedure is minimal.
Laser surgery is effective, bloodless and aseptic, it can be performed in both inpatient and outpatient settings.
Radio wave conization method
This method is less traumatic and widely used in surgical practice. How is conization of the cervix radio waves? When the section coagulates the edges of the incisions, the occurrence of bleeding is excluded. The method characterizes the high accuracy of dysplasia region removal. And minimized effects can increase the chances of a favorable outcome for subsequent pregnancies.
Loop electroexcision method
Answering the question of what is the loop conization of the cervix, how does this manipulation go, it can be noted that the removal of the cone-shaped section of dysplasia is carried out by installing an electrode loop in this area. After that, a high-frequency alternating current is sent to the loop, through which excision is performed.
Tissues with this method are slightly damaged, and the rehabilitation period proceeds well. The pain syndrome is mild and has a short duration. Almost no bleeding occurs.
Knife conization method
It is believed that this method is the most traumatic and can have negative consequences. Therefore, today such an operation is rarely performed. With the appointment of a procedure such as knife conization of the cervix, as they do the operation with a scalpel, it will not be out of place to understand.
The procedure is performed using general or regional anesthesia with the introduction of hemostatic drugs, sometimes doctors dress small arteries.
After this, the affected flesh in the form of a cone is separated by means of a scalpel. After excision, the edges of the incision are coagulated with a spherical electrode to stop the blood flow. Cotton swabs and hemostatic ointments can also be used for these purposes.
Is it possible to get pregnant after manipulation
Having understood what conization of the cervix is, how the procedure is going on using various methods, we will consider the issue of preserving the reproductive function. Experts say that the use of innovative methods of surgery does not actually reduce the chances of a woman becoming pregnant and having a baby. However, there must be an interval of at least a year between the procedure and pregnancy. When planning a pregnancy after conization, a woman should:
- Examined by a gynecologist, oncologist and endocrinologist.
- Pass a smear for cytolocal examination and tests for the presence of hormones in the blood.
- Make a coloscopy of the cervix and ultrasound of the genital organs.
It was found that dysplasia, cured by conization in the first and second stages, practically does not cause complications during pregnancy. And the third and fourth stages of the pathology in combination with other circumstances increase the risk of miscarriages.
Childbirth after the procedure
In this regard, the urgent question is: how are the births after conization of the cervix? The result of manipulation can be a decrease in the organ’s ability to stretch, which makes it difficult to open it, and often the pregnancy ends with a planned caesarean section.
But also, childbirth can be natural, if the observing obstetrician-gynecologist does not see contraindications. In the first year after the birth, it is necessary to undergo an examination by a gynecologist with an interval of 3 months in order to timely detect a new development of the disease, the risk of which increases after pregnancy.
About what the conization of the cervix threatens, how the operation is going on, the reviews are very mixed. It all depends on the stage at which the disease was detected, on the disease itself and on the methods of the procedure. Timely consultation with a doctor helps to identify signs of disease in the initial stages, which will entail the removal of fewer tissues, accelerate the healing process and increase the chances of a favorable outcome of pregnancy and childbirth.