What is cervical conization, how is the operation performed - quite topical issues today. This is a surgical manipulation aimed at the cone-shaped removal of clusters of modified cells. After that, the removed fragment undergoes histology to detect or exclude oncology.
Who is cervical conization indicated for? How is the operation going?
The name of the procedure comes from the word "cone" and refers to the conical cutting of a single tissue fragment. This sectional shape is considered the easiest 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.
Cervical conization is prescribed when a woman has epithelial dysplasia, erosion, polyps, myoma and endometriosis nodes, cysts, large scars(consequences of childbirth), ectropion or eversion of the mucous membrane, the initial stage of cancer.
Before the manipulation, the patient undergoes a thorough examination and the necessary treatment in case of 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 for detection of modified cells and microflora;
- for the detection of infectious agents (PCR diagnostics);
- colposcopy (internal examination of an organ through a colposcope).
A month before surgery, the patient was advised to exclude intimate relationships and maintain personal hygiene.
When such a procedure is prescribed, many women have the first questions: what is cervical conization? How is the operation going? Anesthetized 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 classified as painless. The best time for surgery is considered the first week after the end of menstrual flow, since this practically excludes pregnancy, and there is a rather long time for healing the wound after the operation.
Conization Technique:
- Introduction toplastic speculum vagina.
- Treatment of the cervix with iodine solution to mark the boundaries of the affected tissues.
- Excision of the affected area.
- Extraction of the cut fragment and its further study.
- Cauterize bleeding areas.
Usually manipulation takes 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 cervical cancer in the third or fourth stage was detected during the examination. In this case, there is a risk of cancer cells spreading to neighboring organs. As a result, damage to the vagina, bladder, rectum can occur. The reason for this development of events may not be the error of the operating doctor, but the nature and insidiousness of the tumor itself, which seeks to take root in all parts of the body.
When such a tumor is detected, removal of the entire organ is indicated.
Rehab
Also, many people have questions about the rehabilitation stage after conization of the cervix. How is the healing going?
Full recovery takes several months. After the procedure, women state a brownish bloody secret from the genital tract, which has a specific smell. This may go on for a month. In addition, pain that is aching, pulling or cramping may be disturbing. Don't be afraidif the first menstruation is accompanied by more abundant discharge with clots, this is the norm.
To eliminate discomfort after manipulation, it is recommended:
- taking anti-inflammatory and pain medications;
- abstinence from sexual intimacy until the complete cessation of blood discharge (2-3 weeks);
- exclude the introduction of tampons, suppositories and ointments into the vagina, douching;
- abstaining from taking a bath, visiting the pool and sauna;
- limit physical activity;
- not to be in conditions of elevated temperatures (beaches, solariums, near stoves and ovens).
Two weeks after conization, an examination is required to control the healing process, as well as to identify and prevent possible consequences.
After three to four months, a colcoscopy and a cytological examination of the genitals are performed. By now, the healing process should be complete.
Possible consequences of manipulation
Current surgical methods of conization minimize the development of complications. However, they cannot be completely ruled out:
- Development of bleeding.
- Infection penetration.
- Cervical stenosis (narrowing).
- Violation of the obturator ability of the cervix, which can lead to miscarriage.
- Changing the properties of mucous secretions from the cervical canal.
- Reduced fertility.
Scarring after surgeryrare, because the method of electrocoagulation 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 an electric current.
- Loopback. The method has a minimal risk of complications and an acceptable cost.
- 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 and what are its benefits?
The procedure is performed under short-term general anesthesia using a carbon dioxide laser that imitates the scalpel technique. Before starting 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, while a small fragment of he althy tissue (1-2 mm) is also captured. At the same time, cauterization of the edges occurswounds.
Method benefits:
- reduce pain to a minimum during and after surgery;
- prevent postoperative swelling;
- reduce bleeding during the healing period;
- the laser destroys microorganisms, therefore reducing the risk of infection of the surgical field;
- tissue scarring after the procedure is minimal.
Laser surgery is effective, bloodless and aseptic and can be performed in both inpatient and outpatient settings.
Radio wave conization method
This method is less traumatic and is widely used in surgical practice. How is conization of the cervix performed with radio waves? During the section, the edges of the incisions are coagulated, the occurrence of bleeding is excluded. The method is characterized by high accuracy of removal of the dysplasia area. And minimizing the consequences can increase the chances of a favorable outcome of subsequent pregnancies.
Loop Electroexcision Method
Answering the question of what loop conization of the cervix is, how this manipulation takes place, it can be noted that the removal of a cone-shaped section of dysplastic flesh is carried out by placing an electrode loop on this area. After that, a high-frequency alternating current is sent to the loop, through which the excision is performed.
Tissues with this method are slightly damaged, and the rehabilitation periodflows well. The pain syndrome is weakly expressed and has a short duration. Bleeding is almost non-existent.
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. When prescribing a procedure such as stab conization of the cervix, as is done with a scalpel, it will be useful to figure it out.
The procedure is performed under general or regional anesthesia with the introduction of hemostatic drugs, sometimes doctors tie off small arteries.
After that, with a scalpel, the affected flesh is separated in the shape of a cone. After excision, the edges of the incision are coagulated with a ball electrode to stop the bleeding. Cotton swabs and hemostatic ointments can also be used for this purpose.
Is it possible to get pregnant after manipulation
Having figured out what cervical conization is, how the procedure is carried out using various methods, we will consider the issue of preserving childbearing function. Experts say that the use of innovative methods of surgery does not actually reduce a woman's chances of becoming pregnant and carrying a baby. However, there should be an interval of at least a year between the procedure and pregnancy. When planning a pregnancy after conization, a woman should:
- Be examined by a gynecologist, oncologist and endocrinologist.
- Submit a smear for cytology and hormone testingin the blood.
- Make a colposcopy of the cervix and ultrasound of the reproductive organs.
It has been established 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 question is relevant: how is the birth after conization of the cervix? The result of manipulation may be a decrease in the ability of the organ 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 sees no contraindications. In the first year after childbirth, it is necessary to undergo an examination by a gynecologist at intervals of 3 months in order to timely detect a new development of the disease, the risk of which increases after pregnancy.
Reviews are very ambiguous about what cervical conization threatens, how the operation goes. 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 diseases in the initial stages, which will entail the removal of less tissue, speed up the healing process and increase the chances of a favorable outcome of pregnancy and childbirth.
