The procedure takes about 15 minutes, but pre- and postoperative care take several hours. A cold knife procedure is a medical procedure that involves using a cold metal instrument, such as a scalpel, to cut, freeze, and remove tissue. This includes sexual intercourse, tampons, fingers and douching. The amount of tissue removed varies but is usually about 1.5 cm wide and 1 cm deep. 2020;20:1025. Boulanger et al. When hysterectomy is performed as a primary mode of treatment for high-grade cervical lesions, the percentage of unexpected invasive cancer is much higher than in cases where conization was done. Among them, the rate of positive endocervical cone margins in the post-menopausal group was significantly higher than the rate of positive margins in the pre-menopausal group (16.67 vs. 4.58%, 2=14.843, P<0.001). Data show that diagnostic CKC can provide guidance for choosing appropriate surgical procedures following conization treatment for post-menopausal women. CKC is also a definitive treatment for patients with HSIL. Before She is the former chief of obstetrics-gynecology at Yale Health. Follow your doctors advice for recovery. Eur J Gynaecol Oncol. Well also tell you about any risks involved in the procedure and. In this study, the positive margin rate of CKC was 25.83% in the post-menopausal group, which was significantly higher than that (12.50%) in the pre-menopausal group. 2018 Dec;143(3):306-312. [29] reported that persistent/recurrent disease was found in 50% of patients with positive endocervical and/or ectocervical margins but only in 15% of those whose margins were negative. doi:10.1371/journal.pone.0163793, Kyrgiou M, Mitra, A, Arbyn, M, et al. The efficiency of detecting HSIL and higher lesions through cytological analysis and the HR-HPV DNA test does not differ between post- and pre-menopausal women. Unauthorized use of these marks is strictly prohibited. Get the latest news and updates on MSKs cancer care and research breakthroughs sent straight to your inbox with our e-newsletters. We conducted a retrospective analysis of post- and pre-menopausal patients with high-grade squamous intraepithelial lesion. Youll most likely experience cramping and bleeding intermittently during this time. Incomplete excision of cervical intraepithelial neoplasia and risk of treatment failure: a meta-analysis. Information about personal history (age, gravidity, parity, menopausal age, symptoms, ThinPrep cytologic test (TCT), high-risk human papillomavirus (HR-HPV) test, colposcopic evaluation, final pathological result) was available for every patient. For low-grade abnormal cells, a PAP test may be recommended every year to two years. The procedure, also called cold knife cone biopsy, takes about 15 minutes, but you will be in the hospital for several hours for pre and postoperative care. Call your doctor if your pain gets worse or changes because it may be a sign of a complication. An incompetent cervix occurs when a very large area of the cervix has been removed. There was no significant difference between the 2 groups (2=1.143, P=0.285; Tables 2 and 3). Treasure Island (FL): StatPearls Publishing; 2023 Jan. Would you like email updates of new search results? CSIL often occurs in 25- to 35-year-old women. The examination was classified as unsatisfactory if the entire cervical lesion and transformation zone were not visualized. Long-term risks after the procedure may include: These factors reinforce the importance of consistent, routine follow-ups with your health provider as well as ensuring that any obstetric or gynecologic specialist knows all the details of your medical history. Your test results will tell your healthcare provider if the cells are normal, precancerous or cancerous. During the procedure, the surgical team will monitor your vital signs to make sure that everything is going smoothly. [4] reported that CIN was localized in the canal in 44% of cases after menopause, whereas before menopause, the percentage was only 12%. In addition, if you have any sudden symptoms after the cone biopsy that seem alarming to you, it's important to contact your healthcare provider or seek urgent medical attention. You can reduce the risk of certain complications by following your treatment plan and: Following activity, dietary and lifestyle restrictions and recommendations before your procedure and during recovery, Informing your doctor if you are nursing or if there is any possibility that you may be pregnant, Notifying your doctor immediately of any concerns, such as bleeding, fever, or increase in pain, Taking your medications exactly as directed, Telling all members of your care team if you have allergies. The overall positive margin rate of cold-knife conization (25.83 vs 12.50%; 2=10.106, P=0.001) and rate of positive endocervical cone margins (16.67 vs. 4.58%; 2=14.843, P<0.001) were significantly higher in the post-menopausal group. Currently, the two main excisional strategies for CIN treatment are loop electrosurgical excision procedure (LEEP) or large loop excision of the transformation zone (LLETZ) and cold-knife conization (CKC), which offers deep excision of the cervical transformation zone with minimal damage. Its the part of your uterus that dilates (opens) during childbirth. How is cervical cancer diagnosed? If you're a patient at MSK and you need to reach a provider after. If the patient survives, it may take up to two years before they are able to walk again. What are the steps after? Copyright 2023 Healthgrades Marketplace, LLC, Patent US Nos. Cold knife cone biopsy is also called conization. Hoffman SR, Le T, Lockhart A, et al. This indicates that the operation in post-menopausal women should be performed cautiously, and the cone depth should be increased if necessary to make a thin and high cone. Cheng et al. Later, that sample of tissue is analyzed with a microscope to determine whether it has cancerous cells or precancerous cells. The anesthesiologist or nurse anesthetist will start your anesthesia. This result is similar to that of previous studies. Cold knife cone. 7,752,060 and 8,719,052. The requirement for informed consent was waived due to the retrospective study design. It usually takes about 4 to 6 weeks for your cervix to heal after this procedure. 16 of 120 and 27 of 240 patients in the post- and pre-menopausal groups, respectively, were lost to follow-up. Cheng et al. 2002;76:4953. The positive ectocervical margin rates were 9.16% and 7.92% in the post- and pre-menopausal groups, respectively. In the post-menopausal group, the mean age of the patients was 54 (range=4565) years. Last medically reviewed on February 29, 2016. Your healthcare provider will discuss the risks and benefits of additional cone biopsies based on your test results. Fasting for six to eight hours before the biopsy can help prevent nausea. This indicates that these 2 routine screening methods should be also suitable for post-menopausal women. -. Cone biopsy is also used to diagnose the cause of moderate to severe cell abnormalities. Natural history of cervical intraepithelial neoplasia: a critical review. Copyright 2023, StatPearls Publishing LLC. Ghaem-Maghami S, Sagi S, Majeed G, et al. These cells are called cervical intraepithelial neoplasia (CIN). Shaco-Levy R, Eger G, Dreiher J, et al. We can also use cervicoscopy and microcolposcopy as some authors do [12,13,14]. PLoS One. Pain that doesnt subside with medication. Cold knife cone biopsy is a highly effective way of diagnosing abnormalities of the cervix and treating early stages of cervical cancer. Taking the histological diagnosis of CIN by conization as the golden standard, the consistency of colposcopy-directed biopsy had no significant difference in the post- and pre-menopausal group (75.83 vs. 83.75%, 2=3.273, P=0.07). Google Scholar. Youll probably need to wear sanitary pads during this time. These patients were under observation, and cytology and HPV testing had turned negative.2 cases of VaINII-III patients underwent vaginal lesion resection and vaginal medication. Your care team cannot see anything you write on this feedback form. It can detect cervical cancer or changes in some of the cells of your cervix, typically referred to as cervical dysplasia, that could lead to cervical cancer. For a cone biopsy, this may include not taking aspirin, ibuprofen (Advil, Motrin), and blood thinners. Obstet Gynecol. Meanwhile, consistent with other reports [18,19,20,21],this study found that the rate of positive endocervical cone margins was significantly higher in the post-menopausal than in the pre-menopausal group. Previous data suggest that HSIL is not rare in post-menopausal women. As you recover from a hysterectomy, be patient and listen to your body, so you dont push yourself too hard. Blyss Splane is a certified operating room nurse working as a freelance content writer and former travel nurse. Is there a limit to how many cold knife cone biopsies a woman can have? Your doctor will notify you of the results as soon as possible. Clinical College of Central Gynecology and Obstetrics, Tianjin Medical University, Heping, Tianjin, 300070, Peoples Republic of China, Department of Gynecological Oncology, Tianjin Central Hospital of Gynecology Obstetrics, Tianjin Key Laboratory of Human Development and Reproductive Regulation, 156 Nankai Third Road, Nankai, Tianjin, 300100, Peoples Republic of China, You can also search for this author in Therefore, the effectiveness of surgery of HSIL in post-menopausal women needs to be investigated. 6 . sharing sensitive information, make sure youre on a federal Papalia N, Rohla A, Tang S, et al. The recurrence rate after conization has been reported to be approximately 5% regardless of surgical procedures, while age is a risk factor of recurrence. Your doctor will give you instructions for taking your specific medications and supplements. Cone Biopsy. Minimize the risk of infection by taking care of yourself after the biopsy: Scarring of the cervix and incompetent cervix are rare but are potentially serious risks. You can prepare for a cone biopsy by: Answering all questions about your medical history, allergies, and medications. 2019 Sep;234(9):14975-14990. Notify your doctor if you develop any of the following, as these may be signs of infection: Notify your doctor if you have any of the following symptoms, as they may be signs of a blood clot: Avoid lifting heavy objects or physical strain for four to six weeks after a conization procedure. Among 31 patients with positive margins, 26 cases were HSIL with resection margins, including 22 cases of CIN3 and 4 cases of stage IA1 cervical cancer. By Blyss Splane What to expect the day of your cone biopsy. Predicting residual disease after excision for cervical dysplasia. It can also be helpful to reach out to someone else who's had a cone biopsy, but be selective. As with other fields of medicine, cone biopsies are constantly improving. CIN II and III are more likely to require treatment to prevent cancer. American Cancer Society. there are many strains of hpv, and, yes, the ones that can cause cervical cancer/dysplasia are sexually transmitted. A cone biopsy is a type of surgery that removes a cone-shaped piece of tissue from your cervix. The wide area of tissue removal can increase your chance of premature delivery during pregnancy. Needing to change a sanitary pad every two hours. Cone biopsy involves gently inserting a speculum into your vagina to view and access the cervix. 1997;90:42833. Systematic reviews and meta-analyses of benefits and harms of cryotherapy, LEEP, and cold knife conization to treat cervical intraepithelial neoplasia. The exact timing varies depending on the laboratory. Your cervical tissue goes to a laboratory for analysis under a microscope. To compare the histomorphologic and colposcopic results of cold knife conization and loop excision. Everything to Know, Radiation Therapy Side Effects and How to Treat Them, 7 Symptoms Never to Ignore If You Have Depression. You will not feel or remember this or the surgery as they happen. Chen J-y, Wang Z-L, Wang Z-Y, et al. CKC can provide more exact pathological information, particularly to evaluate CSIL grading and stromal invasion. Predictive factors used to justify hysterectomy after loop conization: increasing age and severity of disease. The day of your surgery, you can generally expect to: Talk with a preoperative nurse. Postoperative pathology showed HSIL and negative margin, and then the patient was reexamined regularly. 4 cases of resection margin were cancer, including 3 cases of stage IB1 and 1 case of stage IA2 cervical cancer, all underwent radical hysterectomy and pelvic lymphadenectomy. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. Google Scholar. Loop electrosurgical excision procedure (LEEP) and cold knife cone (CKC) are often used for the treatment of high-grade cervical intraepithelial lesions. A colposcope is a lighted magnifying glass that guides them to the area that needs to be removed. This is especially important if you have already been diagnosed with cervical precancer or cancer. 2023 BioMed Central Ltd unless otherwise stated. Posterior colposcopy biopsy revealed chronic mucosal inflammation.Only one patient with recurrence had positive margins (Table 7). Article Johns Hopkins Medicine, Wright, J.D., (2016). Johnson N, Khalili M, Hirschowitz L, et al. Dont insert anything into the vagina for 24 hours before your biopsy, including: Stop taking aspirin, ibuprofen, and naproxen for up to two weeks before the biopsy, as directed by your doctor. This can be done in a doctor's office or clinic. Verywell Health's content is for informational and educational purposes only. Loop electrosurgical excision procedure instead of cold-knife conization for cervical intraepithelial . Margins were reported as positive if HSIL or cancer existed at or near (1mm) the resection surface. Knowing what to expect can help make your road to recovery after a cone biopsy as smooth as possible. Bleeding After Hysterectomy: What to Expect, Debra Sullivan, Ph.D., MSN, R.N., CNE, COI. Cold knife conization (CKC) in which a surgical scalpel is used to remove tissue If the edges of the biopsy have cancer cells, the cone biopsy may need to be repeated or a radical trachelectomy (removal of the cervix as well as upper vagina and nearby tissue) may be considered. In our study, only 1 case among all recurrent patients had positive margins, considering both post- and pre-menopausal patients. She works as a freelance content writer for healthcare blogs when she's not spending time with her husband and dog. The anesthesia wears off within a few hours. government site. It is a good idea to carry a current list of your medical conditions, medications, and allergies at all times. [16] demonstrated by a meta-analysis that the positive margin rate of conization was higher in post-menopausal patients. Your doctor may recommend a cone biopsy after other gynecologic screening tests, such as a Pap test, colposcopy, or a cervical biopsy, detect pre-cancer or early cervical cancer. 2007;197:3405. 2014; 349:g6192. Positive margin status in uterine cervix cone specimens is associated with persistent/recurrent high-grade dysplasia. Type III cervical conization is generally preferred in postmenopausal women.All specimens were diagnosed by experienced gynecological pathologists at the Department of Pathology at our hospital. It is the excision of a cone-shaped portion of the cervix to remove a cervical lesion and the entire transformation zone. Pathologic findings of the conization specimens showed that 76 (66.7%) AIS cases were accompanied by squamous cell dysplasia, including 5 (4.4%) with a low-grade squamous intraepithelial lesion. A cone biopsy (conization) is when surgeons remove a cone-shaped wedge of abnormal tissue from your cervix. In our study, the upgrading between biopsy and conization was significantly higher in the post- than in the pre-menopausal group (11.67% vs. 5.42%). Recently, it is being found even in a younger age group. Latif NA, Neubauer NL, Helenowski IB, Lurain JR. J Low Genit Tract Dis. (https://pubmed.ncbi.nlm.nih.gov/26643302/), Visitation, mask requirements and COVID-19 information, LEEP (loop electrosurgical excision procedure). LEEP and cold knife conization allow histologic review of the excised tissue, whereas ablative techniques destroy the transformation zone, precluding histologic evaluation. [6] studied 119 CIN2-3 cases that occurred in post-menopausal women, accounting for 6.5% of the 1,810 cases. The pathologic margin of specimens from cold knife conization is less frequently involved and is easier to. 12 2009 1573 Comparison of Success Rate and Complications of Contour-Loop Excision of the Transformation Zone (C-LETZ) with Cold Knife Conization (CKC) in High Cold knife cone biopsies let your doctor take a larger amount of tissue. This procedure is done in the operating room using general or regional anesthesia for pain control. Skjeldestad FE, Hagen B, Lie AK, et al. All patients underwent colposcopy, of which 46 (38.33%) and 171 (71.25%) cases in the post-menopausal and pre-menopausal group, respectively, were satisfied with colposcopy. The first 4 days after your procedure, you may have vaginal discharge that looks like menstrual bleeding. The patient with vaginal squamous cell carcinoma underwent chemotherapy. Obstet Gynecol. BMC Womens Health. The .gov means its official. Cheng X, Feng Y, Wang X, et al. If postoperative pathology of cervical invasive carcinoma, positive margins, extensive lesions, residual lesions, or uterine or ovarian lesions were identified, then further surgery was required. Chen Y, Lu H, Wan X, et al. The specimen is then examined using a microscope. official website and that any information you provide is encrypted You are often given only local anesthesia and you can return home much more quickly after the procedure. This schedule varies depending on your age and medical history. It's often performed after an abnormal Pap test. [6] reported that the overall positive margin rate of conization in post-menopausal patients was as high as 20.8%, which was significantly higher than that (10.9%) in pre-menopausal patients. [8] concluded that postmenopausal women with normal cytology testing positive for HR-HPV mRNA were at increased risk for the development of high-grade cervical intraepithelial neoplasia, in contrast to women with a negative HR-HPV mRNA outcome.Hence, post-menopausal women should undergo regular cervical cancer screening. The procedure, also called cold knife cone biopsy, takes about 15 minutes, but you will be in the hospital for several hours for pre and postoperative care. J Midlife Health. Pathologe. Cytological analysis results revealed a 30.91% (34/110) diagnosis consistency between the cytology and biopsy histology in the post-menopausal women and 32.16% (73/227) in the pre-menopausal women. Predictive factors from cold knife conization for residual cervical intraepithelial neoplasia in subsequent hysterectomy. University of Washington. An anesthesiologist will talk to you about your medical history. Acta Obstet Gynecol Scand. Punch biopsy is a less invasive kind of cervical biopsy that removes small areas of tissue. However, it is not a standard treatment. 2015 Apr;19(2):97-102. doi: 10.1097/LGT.0000000000000055. Some literature [25,26,27,28] reported that incidence of CSIL relapse was 2.5% to 8.5%. Miroshnichenko GG, Parva M, Holtz DO, Klemens JA, Dunton CJ. Int J Gynaecol Obstet. Therefore, we should pay attention to cervical cancer screening in post-menopausal women. 10 Overprescribed Medical Tests and Treatments. 2001;95:17580. A total of 245 women underwent cervical conization (cold knife cone or loop electro-surgical excisional cone) for the following indications: CIN grade 2 or 3, positive endocervical curettage (ECC . Your doctor is unable to see or access abnormal cervical tissue with colposcopy. Talk with the anesthesiologist or nurse anesthetist about your medical history and the type of anesthesia you will have. While both techniques are associated with equivalent efficacy . Your doctor may choose a cold knife cone biopsy if theyre not able to gather enough tissue through a punch biopsy. A cone biopsy is surgery to remove abnormal cells from the cervix. Cochrane Database Syst Rev. Among them, 6 cases of leiomyoma, 2 cases of adenomyosis, 1 case of ovarian endometriosis. However, the positive margins are a major problem. There are different types of cervical biopsies. Interventions for preventing blood loss during the treatment of cervical intraepithelial neoplasia. This patient relapsed after 28months of follow-up. The rates of residual disease of positive and negative margins were 60.87and 16.22%, respectively. Obstet Gynecol. [7] reported that the infection rate of HPV in post-menopausal women was 9.55%. When you have a migraine, you'd try anything to feel better. Sometimes. Endocervical margin status and severity of neoplasia significantly predicted the occurrence of persistent/recurrent disease after conization. These patients with recurrence underwent subsequent extrafascial hysterectomy. If the cone biopsy did not remove all of the abnormal tissue, a repeat cone biopsy may be performed or additional treatments may be recommended. In one study, a 98% cure rate with both laser conization (n=439) and cold-knife conization (n=212) was reported. American Cancer Society. 1999 Apr;73(1):12-5. doi: 10.1006/gyno.1998.5300. Cryosurgery is a type of ablation where a very cold metal probe is placed directly on the cervix. Am J Obstet Gynecol. Persistent intraepithelial neoplasia after excision for cervical intraepithelial neoplasia grade III. J Low Genit Tract Dis. What kind of assistance will I need at home? An obstetrician-gynecologist (Ob/Gyn) performs a cone biopsy. The effectiveness of conization treatment for post-menopausal women with high-grade cervical intraepithelial neoplasia. Lean on your family, friends and healthcare team for support. The risks associated with cold knife cone biopsy are minimal. -, Chen M, Cai H, Chen S, Wu X, Ma X, Liu M, Chen L. Comparative analysis of transcervical resection and loop electrosurgical excision in the treatment of high-grade cervical intraepithelial neoplasia. Policy. LEEP biopsies are often performed in a doctor's office or clinic. In the post-menopausal group, 14 patients were diagnosed as having invasive cervical cancer following conization treatment, including 9 stage IA1, 1 stage IA2, and 4 stage IB1. Methods. A low-grade fever (lower than 100.5 degrees Fahrenheit) is common for a couple of days after surgery. 2007;8:98593. Asciutto KC, Borgfeldt C, Forslund O. Wash your hands before and after using the bathroom. 2 patients underwent hysterectomy because of leiomyoma, and 5 patients underwent extrafascial hysterectomy because of concern about disease progression or absence of follow-up conditions. For 4 to 6 weeks after your procedure or until your healthcare provider tells you your cervix is healed: Your next period may be late, or you may have a heavier blood flow than usual. They can answer any questions you may have before the procedure. Penna CL, Fambrini M, Fallani MG, et al. mild-to-moderate cramping, progressing to severe pain. Mayo Clinic Staff. Philadelphia, PA: Elsevier. There are a number of ways you can cope with the anxiety and stress you may feel while waiting for your mammogram results. Prediction of residual neoplasia based on histopathology and margin status of conization specimens. 2007;9:24. After cryosurgery, you may have a watery brown discharge for a few weeks. Precancerous cells fall into these categories: In each case, your healthcare provider will let you know whether the cone biopsy was able to remove all the abnormal tissue. Synthetic hygroscopic cervical dilator use in patients with unsatisfactory colposcopy. Whatever method is used to excise a sample, the amount of tissue collected will likely measure around 1.5 centimeters (cm) wide and 1 cm deep. Normally, type I resection is used for type 1 transformation zone, and the resection depth is 710mm. Your care team will give you blankets for modesty and warmth. 9 patients underwent hysterectomy because of amalgamative uterine or ovarian disease. 2003 Oct;102(4):726-30. Exp Ther Med. Use sanitary pads for vaginal discharge. Don't hesitate to ask them any questions you have before your procedure. Cone biopsy is an outpatient procedure, which means you dont stay overnight. Your provider should have the results of your biopsy within about a week. This procedure is usually done in an operating room after the patient has received general anesthesia (medicine given to induce sleep) or regional anesthesia (eg, epidural or spinal). In the first 24 hours after your procedure: The first 4 days after your procedure, you may have vaginal discharge that looks like menstrual bleeding. There was no significant difference between the 2 groups (28.57 vs. 33.33%, 2=0.285, P=0.593). Clin Exp Obstet Gynecol. doi: 10.1136/bmjopen-2017-017576. Treatment of CIN after menopause. In another patient,the cytology showed LSIL and HPV was positive. You may feel weak, tired, and have mild abdominal cramping for one to two days. If your procedure is done in the office, the team may only consist of the doctor and a medical assistant. Find out how these treatments work, and what to expect. Interpretability of excisional biopsies of the cervix: cone biopsy and loop excision. Int J Biomed Sci. These factors were compared between the post- and pre-menopausal groups. Philadelphia: Lippincott Williams & Wilkins, 2008. A cone biopsy may cure your condition or significantly reduce your risk of developing a more serious condition such as cervical cancer. Our scientists pursue every aspect of cancer researchfrom exploring the biology of genes and cells, to developing immune-based treatments, uncovering the causes of metastasis, and more. Your cervix is the part of your body that separates the upper part of your vagina and the lower part of your uterus. Systematic reviews and meta-analyses of benefits and harms of cryotherapy, LEEP, and cold knife conization to treat cervical intraepithelial neoplasia. Dont put anything inside your vagina (such as tampons and douches) or have vaginal intercourse. Preterm birth prevention post-conization: A model of cervical length screening with targeted cerclage. -, Schmidt D. [Squamous cell precancerous lesions of the cervix uteri]. The US healthcare system can over treat patients for a variety of reasons. HHS Vulnerability Disclosure, Help J Low Genit Tract Dis. i'm sorry to hear that your doctor did not explain about hpv and how you would have developed dysplasia. Submission of this form is subject to Healthgrades, Help Millions of people find the right doctor and care they need, Get immediate care and visit with providers from the comfort of your home, or anywhere, Urgent care centers can be faster and cheaper for situations that are not life threatening, Doctors and patients discuss the latest medical treatments and health tips, Search prescription drugs for why theyre used, side effects and more, Back and Neck Surgery (Except Spinal Fusion), http://www.dana-farber.org/Health-Library/Cervical-cone-biopsy.aspx, http://www.acog.org/~/media/For%20Patients/faq135.pdf?dmc=1&ts=20130830T1246282949, http://www.asccp.org/Portals/9/docs/pdfs/Patient_Education/Cone_Biopsy.pdf, http://www.cancer.org/cancer/cervicalcancer/detailedguide/cervical-cancer-diagnosis. The positive margins were 44% (267/607) after LEEP and 29% (274/952) after CKC. Moreover, 49 post- and 60 pre-menopausal women underwent subsequent surgical treatment (40.83 vs. 25.00%). This procedure is most commonly used for the removal of larger tumors and cysts, for biopsies of suspicious lesions, and for the extraction of childbirth membranes. Int J Gynaecol Obstet. This occurs throughout the procedure and during recovery until you are alert, breathing effectively, and your vital signs are stable. Since you'll probably be under general anesthesia, you must stop eating and drinking for several hours before the procedure. Not eating or drinking before surgery as directed. Cone biopsy is a more complicated surgery, and surgeons perform it under general anesthesia. Cone biopsy is a treatment option to remove abnormal and precancerous cells from your cervix. Asian Pac J Cancer Prev. Evaluation of neutrophil-lymphocyte ratio as a prognostic factor in cervical intraepithelial neoplasia recurrence. Patients whose resection margins were cancer and did not preserve fertility underwent radical hysterectomy and pelvic lymphadenectomy.Cytology analysis and HR-HPV DNA test were required during follow-up,and those with abnormalities were referred for colposcopy, cervical biopsy and endocervical curettage(ECC).Recurrence was defined as histopathological HSIL during follow-up. From diagnosis to treatment, our experts provide the care and support you need, when you need it. Journal of lower genital tract disease,24(2), 102131. Wright TC, Massad LS, Dunton CJ, et al. CKC can be performed as a primary procedure for diagnosis and treatment in post-menopausal patients with HSIL. You need treatment of precancerous cells or very early cervical cancer. Dont hesitate to ask questions about the procedure and your results. Those who have preexisting health conditions such as heart, lung, or kidney disease might have increased risks while receiving general anesthesia. Our results showed that the satisfactory rate of colposcopy was significantly lower in the post- than in the pre-menopausal group.