A cone biopsy (conization) is a procedure in which surgeons remove a cone-shaped wedge of abnormal tissue from the cervix. The tissue is sent to a lab to be tested for precancerous or cancerous cells. It is often performed after an abnormal Pap test. Cone biopsy (also known as conization or cold knife biopsy) is a surgical procedure to remove abnormal tissue from the cervix. The procedure can detect cervical cancer or changes in some of the cells of the cervix, commonly called cervical dysplasia, that can lead to cervical cancer. It’s called a cone biopsy because the surgeon cuts a cone-shaped piece of irregular tissue from the cervix. This type of biopsy allows them to reach the deeper layers (or inner parts) of the cervix. The tissue is then sent to a laboratory for further testing. A cone biopsy is an outpatient procedure performed in a surgery center or hospital. Cone biopsy is a treatment option to remove abnormal and precancerous cells from the cervix. It also diagnoses precancerous and cancerous cells in the cervix. The procedure is performed in the following situations: Pap smear detects changes in the cells of the cervix that can lead to cervical cancer; If you need treatment to remove abnormal cells on the cervix, if they are cancerous or precancerous; In treatment to remove early stage cervical cancer (stage 0 or IA1); The treating physician may suggest a cone biopsy when other methods such as colposcopy or punch biopsy do not find the cause of the abnormal cell changes. Post-procedure recovery takes place in the hospital or surgery center a few hours later. The attending physician monitors the blood pressure, pulse, bleeding and pain to make sure that the recovery is going well and the patient can go home. After the procedure, patients report period-like pain for several days. These symptoms can be controlled with non-steroidal anti-inflammatory drugs. Most women can return to their daily activities after about a week. Cramping and bleeding are normal for the first week after the procedure. It is normal for vaginal discharge to change from red or pink to light brown. Some doctors provide a list of activities that need to be avoided until the follow-up appointment. Some of the items on this list may include: Abstaining from intercourse for the first four weeks after the procedure, as well as avoiding the use of tampons and vaginal douches. It is necessary to avoid heavy lifting and heavy physical exercises. Avoiding swimming in pools or using hot tubs. A follow-up examination is necessary four to six weeks after conization.After the cone biopsy, your doctor may recommend a Pap test every six months. After several consecutive Pap smear results return to normal, a more typical pap smear schedule (once a year) will be switched. This schedule varies based on age and prior medical history. References: 1. Canadian Cancer Society. Cone biopsy. (https://cancer.ca/en/treatments/tests-and-procedures/cone-biopsy) 2. Cancer Research UK. Cone biopsy. (https://www.cancerresearchuk.org/about-cancer/cervical-cancer/getting-diagnosed/tests-diagnose/cone-biopsy) 3. Cooper DB, Carugno J, Menefee GW. Conization Of Cervix. (https://www.ncbi.nlm.nih.gov/books/NBK441845/) [Updated 2021 Dec 16]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan 4. Kim ML, Hahn HS, Lim KT, et al. The safety of conization in the management of adenocarcinoma in situ of the uterine cervix. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3097330/) J Gynecol Oncol.