Conisation of the cervix under local anaesthesia

The purpose of this leaflet is to provide the patient with information on the purpose, nature and course of the surgical procedur, preparation for the procedure and recovery after the procedure.

Cervical conisation is a surgical treatment in which a conical piece of tissue is removed from the outer part of the cervix.

The purpose of conisation is to cut out the area of the cervix with altered cells. Cervical conisation is performed on patients with moderate to severe cervical dysplasia.

In the case of dysplasia, cell growth is impaired. In moderate dysplasia, changes include one-half to two-thirds of the surface epithelium of the cervix. In the case of severe dysplasia, the growth of whole surface epithelium cells is disrupted, but the altered cells do not penetrate deeper into the basal plate of the basal layer.

Preparation for surgery

To reduce the risk of complications, please inform your doctor before the surgery:

of your state of health, including all illnesses and medications you are taking regularly;
of your known allergies to medications; and
if you have a pacemaker.

It is recommended to eat and drink the morning of the surgery.

Course of the operation

Conisation of the cervix is performed by a gynaecologist under local anaesthesia. The cervix is injected with a local anaesthetic (Lidocaine). The conical part of the cervix is removed with an electric loop or a scalpel. The removed tissue sample will be examined histologically.

Possible complications

Complications may occur during the surgery. Possible complications include:

allergic reactions to administered medications;
bleeding that may occur immediately after conisation or up to one to two weeks later.

If an electric loop is used to perform the operation, the skin in the electrode area may be damaged. Electric vaginal ulcers can also occur on the vaginal mucosa and labia. A late complication in the form of a fistula may occur between the bladder and the vagina or between the vagina and the rectum. The abovementioned complications are very rare.

Postoperative period

After the surgery, you will be allowed to go home.

After conisation, the cervix heals within five weeks. There may be a small amount of bleeding and an unpleasant smelling discharge during this period.

Here are some tips to help you get better:

In those five weeks, it is forbidden to have sexual intercourse, take a bath or swim, as these activities can cause bleeding or inflammation.
Physical exertion and exercise should be avoided for three weeks.
It is not recommended to use tampons (even during menstruation) or vaginal balls for four to six weeks.

Postoperative bleeding is most common between the 6th and 14th day after surgery. Occasionally, mild lower abdominal pain may occur after conisation.

Please note! If you develop heavy bleeding, a fever or severe lower abdominal pain, you should contact the Women's Clinic emergency on-call room at 18 Ravi St, Tallinn.

Unless you have been told otherwise, you can find out the results of the histological examination from your outpatient gynaecologist.

If you have any questions or need more information, please consult your doctor.

ITK1079

Approved by the decision of the Care Quality Commission of East Tallinn Central Hospital on 20.04.2022 (protocol no. 6-22