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Cone biopsy

A cone biopsy is a small operation to remove a cone shaped piece of tissue from your cervix.

You usually have it under general anaesthetic, which means you are asleep. The operation takes about 15 minutes. You will probably stay in hospital overnight. 

Why you might have a cone biopsy

You might have a cone biopsy if you have symptoms that could be caused by cervical cancer.

It's also a treatment for abnormal cervical cells that have been picked up through cervical screening. The abnormal cells might be on the outer surface of the cervix, or the inner part of the cervix (the cervical canal). If left untreated, abnormal cervical cells might develop into cervical cancer.

Before the cone biopsy

Your specialist will check that you are fit and well enough for a general anaesthetic.

Having a general anaesthetic means that you won’t be able to eat or drink for a number of hours beforehand. You usually stop eating at least 6 hours before the procedure. You can usually drink water up to 2 hours beforehand. Your appointment letter will give you instructions about this.

What happens

During the operation, your doctor puts a speculum into your vagina so that they can see the cervix. This is similar to when you have cervical screening or a colposcopy. Your doctor removes a cone shaped wedge of tissue from your cervix.

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They send the piece of tissue to the laboratory where a pathologist looks at it closely under a microscope. They can check that all the abnormal cells have been taken away, or can check for cancer cells.

Your doctor might pack your vagina with some gauze. This is to put pressure on your cervix to help stop any bleeding. They may also put a tube into your bladder (catheter) to drain urine while the pack is in place.

After your cone biopsy

After the operation, you go back to the ward. Your nurse checks your blood pressure, pulse and temperature, and looks for signs of bleeding.

You will probably have period type pain when you wake up. Tell your nurse if you have any pain. They can give you some painkillers. You can take painkillers home with you if you need to, but the pain usually only lasts a couple of hours.

Once you are fully awake you can eat and drink.

Your nurse or doctor will take the gauze pack out before you leave hospital. You need to rest on the bed for a couple of hours afterwards to make sure there isn't any heavy bleeding.

It is normal to have some bleeding for up to 6 weeks after a cone biopsy. Your doctor may prescribe a drug called vasopressin or tranexamic acid that can reduce the bleeding.

At home

Try to rest as much as you can for the first week or so. You do not have to stay in bed. But you shouldn't be too active either.

Don't do any heavy housework or carry heavy loads. It will help if you can arrange for a relative or friend to help you for a few days, particularly if you have children to look after. Most women are able to go back to work within 1 or 2 weeks.

You shouldn't do any vigorous exercise or have sexual intercourse for 4 to 6 weeks after your cone biopsy. By that time your cervix will have healed.

Getting your results

Before you leave hospital, make sure you know how you will be given the results. You might go back to the hospital for an outpatient appointment to get the results. Or the results may be sent in the post.

If you had a cone biopsy for abnormal cells, you usually have a follow up appointment about 6 months afterwards. This might be at the colposcopy clinic or GP surgery. The cone biopsy usually removes all of the abnormal cells so you don't need any further treatment. You continue with regular cervical screening tests to make sure your cervix remains healthy.

If you are diagnosed with cervical cancer, your doctor will arrange for further tests. You will meet a specialist cancer nurse to help support you.

Possible risks

Cone biopsy is normally a safe procedure but your nurse will tell you who to contact if you have any problems after your test. Your doctors make sure the benefits of having a cone biopsy outweigh any possible risks.

Bleeding

There is a small risk of heavy bleeding. Your nurse will check you regularly after your operation for signs of bleeding.

Contact your GP or go to accident and emergency (A&E) if you start to bleed heavily or pass blood clots once you are at home. You may need treatment to stop the bleeding.

Infection

There is a small risk of infection after the biopsy. See your GP if you have:

  • vaginal discharge that smells
  • pain in your lower tummy (abdomen) that doesn't go away
  • high temperature (fever) 

You might need antibiotics.

To reduce the risk of infection, avoid having sex and using tampons for up to 6 weeks after the biopsy.

Narrowing of the cervix

After a cone biopsy there is a very small risk that the cervix may narrow. You might need surgery to stretch (dilate) the cervical opening.

Pregnancy

Your doctor will not suggest a cone biopsy if you are pregnant unless they suspect there is a cervical cancer.

A cone biopsy can weaken the cervix. This can increase the risk of miscarriage or early labour in future pregnancies.

If you have questions about having a cone biopsy, contact the Cancer Research UK information nurses on freephone 0808 800 4040. The lines are open from 9am to 5pm, Monday to Friday.

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