Cone biopsy is usually performed to test the presence of cervical cells in the cervix, where a small cone shaped piece of tissue is removed from the cervix. It is generally performed after a Pap test which indicates the presence of cancerous cells in the cervix. What is cervix? The cervix is the bottom part of your uterus. It connects the uterus to your vagina. Therefore, it remains closed most of the time and dilates or opens during labour. Moreover, menstrual blood flows through the cervix to your vagina and out of the body.
A cone biopsy can also be used to treat abnormal cervical cells that have been picked up during a screening. The abnormal cells might be on the surface of the cervix or the inner part of the cervix (the cervical canal). The risk of developing cervical cancer is greater for women aged between 21 and 30 years and should go for monthly screenings or Pap tests.
Cone biopsy is generally performed by a gynecologist but involves a pathologist and anesthetic as well. Therefore, a general anesthetic is given to patient and you won’t be able to eat or drink at least 6 hours prior to the operation. The whole operation takes about 15 minutes in total.
The whole procedure of cone biopsy takes 15 to 20 minutes to perform. Your doctor will use a speculum to keep the vagina open. The small tissue taken from the cervix is either extracted by using a scalpel or a loop electrosurgical excision procedure (LEEP) which uses low-voltage, high voltage frequency to excise tissue. After which the cone shaped wedge of tissue is sent to the laboratory where the pathologist looks at the tissue under a microscope. They either check for abnormal cells or check for cancer cells at the cervix.
The doctor will put some gauze in your vagina to put pressure on your cervix so that the bleeding stops. They also put a tube into your bladder (catheter) to drain urine from your body.
You will be required to stay in the hospital for 5 days during which you will be monitored by a nurse. You will probably have period like pain when you wake up for which you will be given painkillers. It’s normal to bleed for up to 6 weeks after a cone biopsy for which the doctor may give drugs like vasopressin or tranexamic to reduce the bleeding.
A person having cervical cancer with symptom like abnormal bleeding (between periods, after sex, or after menopause), heavier than normal periods, pain during sex and unusual vaginal discharge that might contain blood is eligible for this procedure. It is also performed after a Pap test or the presence of abnormal cells in the cervix.
People suffering from other type of cancer like lung or blood is not eligible for the procedure of cone biopsy.
Although cone biopsy is safe procedure but you can experience side effects like bleeding and infection that might lead to smelly vaginal discharge, pain in your lower abdomen and fever.
Another complication that may arise due to cone biopsy is narrowing of the cervix which is known as cervical stenosis. The cervix may become so tight that a sperm is unable to enter the uterus to fertilize the egg. Therefore, you may need additional surgery to stretch or dilate the cervical opening. Moreover, women who had cone biopsy have a higher chance of their babies being born before 37 weeks or a higher risk of a low birth weight of the baby, less than 2.5 kg or an increase in birth by caesarean section.
When you come home from the hospital, you should rest for the first week or so. It’s not important to lie in bed all day but you can physically active as well. Do’t do heavy housework or carry heavy loads. Also don’t do any exercising (like running or aerobics) and abstain from doing sexual intercourse for at least for 4 or 6 weeks. Moreover, don’t use tampons or douches instead use sanitary pads. You will be required to use sanitary pads for at least 2 to 3 weeks as you will bleed for the first few days which will turn watery. Refrain from tub baths instead take showers.
You should also follow it up with an appointment with your doctor after 6 months or even earlier if you feel any discomfort at any point of time. Don’t get worried if you are not getting a period as you will probably get a late period post-surgery.
The recovery period for cone biopsy usually range from two to four weeks.
The procedureis generally done for early stage of cancer and is very cost effective. It usually range from Rs.13000 and go up to Rs. 2,00,000
If your cancer is at an early stage, then the results of the procedure is permanent. However, there is gaurantee for cancer and it can reoccur after a period of time.
Other alternative treatments for cone biopsy includes cryotherapy or laser vaporization that can treat early-stage cancer. A hysterectomy is also used in place of cone biopsy. There are two types of hysterectomy, one is subtotal where the uterus is taken away and the other is radical hysterectomy where the uterus, cervix, ovaries, fallopian tubes, lymph nodes and lymph channels are taken out.