Conization is a small surgical intervention performed on women who have pre-cancerous lesions in the cervix. It is a preventive measure characterized by the removal of the tissue that may cause problems in the future.
These injuries can occur due to the Human Papilloma Virus (HPV), which is considered a sexually transmitted disease (STD). It can be detected thanks to a gynaecological examination by observing it during or after the cytology.
This surgery has two main goals:
- Treating injuries that can develop into a future uterine cancer. Premalignant lesions are removed to avoid future problems. It is a preventive measure against cancer.
- It is also used as the definitive diagnosis of an injury, ruling out the existence of an early-stage uterine cancer.
The procedure is relatively simple and does not require hospitalization. There are two types of procedure: with local anaesthesia and with mild general anaesthesia, which is the most common. After a few hours, and after the patient’s response to the intervention has been checked, she can leave the clinic.
Advice for the patient
Depending on how the procedure is performed, preoperative conditions vary. If the conization is performed under local anaesthesia, fasting is not required. When general anaesthesia is used, the patient should not eat during the 8 hours that precede the intervention.
Once conization is done, the patient should:
- Rest for 3 or 4 days.
- Limit physical activity for two weeks.
- Not engaging in sexual activity during 4 weeks.
- Asking a doctor if there’s heavy vaginal bleeding or heavy vaginal discharge and odour. A little vaginal bleeding after surgery is normal. The disappearances of vaginal flow during the days following the intervention is also normal.
Connection with fertility
This intervention involves a number of risks, such as bleeding, infection, cervical incompetence, scarring of the cervix…
We should not directly link this intervention with uterine cancer, since this intervention is performed to prevent a possible cervical cancer.
Many women who undergo this procedure worry about its potential effects on fertility and about the problems that might arise when they try to become mothers in the future. It is difficult to answer this question, since until the woman tries to get pregnant not all consequences of the intervention are observed.
Egg quality is not compromised by this intervention, since the ovaries do not suffer any alteration. A possible problem is related to the intervention of the wound during embryo implantation. This happens rarely, since the procedure is performed in the cervix and the embryos implant near the uterine fundus.
The most common consequences of this intervention are preterm birth. When the cervix is shortened, childbirth may be anticipated.
Although not common, scarring of the cervix can also happen. This would prevent sperm from accessing the uterus and a natural pregnancy from being achieved. When this happens, the patient must resort to assisted reproductive techniques in order to have a child.