Having a cone biopsy
This information has been written to explain your operation and the benefits and risks.
The medical and nursing staff will be happy to answer any questions you may have.
Why do I need a cone biopsy?
Your smear test/colposcopy has shown some abnormal cells (sometimes called CIN or
cervical intraepithelial neoplasia) on your cervix. It is important to remember that it is very
rare for these cells to be cancerous. However, if left untreated they may (in some patients)
turn cancerous in time.
These abnormal cells are removed from the neck of the womb by a cone biopsy. Your
Consultant will decide if this is appropriate, and this will be discussed with you.
What is a cone biopsy?
A cone biopsy is performed to diagnose and remove abnormal cells. A “cone” of tissue
containing the abnormal area is cut away using a scalpel.
The tissue is sent to the laboratory for examination to confirm the diagnosis and to check if
all the abnormal cells have been removed.
What is involved?
This procedure is performed under a general anaesthetic (which means you will be asleep
throughout) and takes approximately 15 minutes.
Please ensure you are using contraception during your current cycle or avoid unprotected
intercourse as the treatment will not be performed during pregnancy. If there is doubt, a
pregnancy test may be performed before treatment is given. However, as this may remain
negative in very early pregnancy it is advisable to take measures to avoid pregnancy when
awaiting treatment.
What are the benefits of having a cone biopsy?
This method of treatment is 95% successful, resulting in a normal smear at the 6 month
follow-up appointment.
Are there any risks involved in having a cone biopsy?
As with any procedure, there is a small chance that you may have side-effects or
complications which include:

Heavy bleeding may occur immediately after your procedure or after 10 - 14 days
following the procedure.

There is a small risk you may develop an infection that will require antibiotic
treatment.

Rarely, the cervix may be weakened. Cone biopsy does not appear to be a cause of
infertility or miscarriage, but is associated with a small increase in the incidence of
preterm labour and preterm rupture of membranes (waters breaking).

The cervix may narrow due to scarring in 1 in 5 cases. This may require further
surgery to dilate (stretch) the cervical opening.
Your consultant considers that the potential benefits from this procedure are far greater
than any risk of complications in your case.
If you are concerned about any of these risks, or have any further queries, please speak to
your consultant.
Alternatives
Your consultant will inform you if any alternatives are appropriate, as the options depend
upon your medical history for example the area of affected cells, your age and any
problems with periods. Examples may include LLETZ or rarely a hysterectomy if it is not
feasible to do a cone biopsy or LLETZ safely.
What should I expect after the operation?
You may have a gauze pack put into your vagina at the time of your operation to reduce
any bleeding. The pack will be removed on your doctor’s instructions, usually the morning
after.
You will be advised to rest on your bed for a couple of hours to check there is no heavy
bleeding.
Sometimes you can go home later the same day (a friend or relative would need to drive
you home) occasionally you will need to stay in hospital longer (1 - 2 days).
DISCHARGE INFORMATION AND AT HOME ADVICE
Pain relief
Many patients do not have pain afterwards. However, you may feel some abdominal
discomfort. If so, please take some Paracetamol - follow the manufacturer’s instructions
and do not exceed the stated dose.
Bleeding
Some light bleeding, brownish/black or watery discharge is expected for up to 6 weeks.
Your period may be light or heavy, early or late for 2 - 3 months following treatment.
It is advisable to avoid tampons for 4 weeks.
Any other discharge, particularly if offensive in smell or bright red bleeding, heavy and
fresh in nature, should be reported to your GP.
Sexual intercourse
To reduce the risk of infection/bleeding, please refrain from vaginal intercourse for 4 weeks
to allow the cervix to heal as quickly as possible.
Returning to normal activities and work
Avoid swimming for 2 weeks following treatment.
Usual activity, including light exercise, may continue as normal.
Although there are no known health grounds for avoiding travel following treatment,
overseas medical attention for complications arising from treatment may not be covered by
insurance. Please let the clinic staff know if you are planning to travel abroad in the few
weeks following treatment.
You may return to work as soon as you want to and feel able to do so. However as you
have had a general anaesthetic you are advised to rest at home for 24 hours.
Alcohol
Alcohol may be consumed in moderation unless you have been given an antibiotic called
Metronidazole in which case alcohol should be avoided.
Follow up appointment
You will be given a letter to give to your GP as soon as possible after returning home. If an
outpatient clinic appointment is needed an appointment will be sent to you through the
post.
You may need to attend the outpatient department in 6 months time for a smear test and
sometimes a colposcopy. This appointment is important to ensure your treatment has been
successful and to check the cervix. Your doctor will inform you if he/she has decided on a
different follow-up schedule.
For most patients, a cone biopsy will remove all abnormal tissue and no further treatment
will be required. It is important to keep your follow up appointments for regular check ups
as advised by your doctor to make sure that your cervix remains healthy.
Can the problem come back?
Sometimes the problem may continue. If so it is most likely in the first 2 - 3 years. This is
why you will have a follow up smear and HPV test (a virus that can cause cell changes in
some women) to make sure your cervix remains healthy.
If you have any queries, or require further information
please contact Ward 209a on 01332 785017.
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