Cold knife cone biopsy

Definition

A cold knife cone biopsy is a procedure to get a sample of abnormal tissue from the cervix for further examination.

How the test is performed

This is a surgical procedure. It is done in the hospital while you are either sedated through an IV or general anesthesia. The purpose of this procedure is to diagnose and treat precancerous changes in the cervix.

A small cone-shaped sample of tissue is removed from the cervix and examined under a microscope for any signs of cancer. This biopsy may also be the treatment if the doctor removes all of the diseased tissue.

How to prepare for the test

As with any procedure that is done under anesthesia, you will probably need to fast for 6 - 8 hours. You must sign an informed consent form. The procedure is done on the same day (outpatient) and a hospital stay is usually not needed.

How the test will feel

After the procedure, you may have some cramping or discomfort for a week or so. For about 4 - 6 weeks avoid:

Douching
Sexual intercourse
Using tampons

For 2 - 3 weeks after the procedure, you may have discharge that is:

Bloody
Heavy
Yellow-colored

Why the test is performed

This test is only done if the health care provider knows or suspects that you have abnormal cells in the cervix.

It may be done if a biopsy of the cervix shows that you may have precancerous cells in the area or cervical cancer. A cold knife biopsy may also be done if a cervical biopsy cannot find the cause of an abnormal Pap smear.

Normal Values

There are no precancerous or cancerous cells in the cervix.

What abnormal results mean

Most often, abnormal results mean that there is an area of precancerous or cancerous cells.

What the risks are

Bleeding
Incompetent cervix (which may lead to premature delivery)
Infection
Scarring of the cervix (which may cause painful menstrual periods, make it more difficult for doctors to read an abnormal Pap smear, and make it harder to become pregnant)

References

Katz VL, Lentz GM, Lobo RA, Gershenson DM. Comprehensive Gynecology. Philadelphia, Pa: Mosby; 2007.

Reviewed on February 19, 2008 by Peter Chen, MD, Department of Obstetrics & Gynecology, University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.