Who is assigned conization of the cervix? How is the operation?

What is the conization of the cervix, how is the operation performed - quite topical issues to date. This is a surgical manipulation aimed at the conical removal of clusters of modified cells. After that, the deleted fragment passes a histology to identify or exclude oncology.

Who is assigned conization of the cervix? How is the operation?

The name of the procedure is derived from the word "cone" and denotes the tapering of a single piece of tissue. This form of section is considered to be the easiest type of surgical intervention, considering the structure of the organ, the placement of blood vessels. In addition, the surface of the neck does not form scars and deformities.

Conization of the cervix is prescribed when a woman has dysplasia of epithelium, erosion, polyps, mimatosis and endometriosis nodes, cysts, large scars (effects of labor), ectropion or eversion of the mucosa, the initial stage of cancer.

Before the manipulation, the patient undergoes a thorough examination and the necessary treatment for the detection of inflammatory processes in the genitals. For this, the doctor prescribes tests:

• General blood and urine tests;
• Blood biochemistry;
• Analyzes for hepatitis B and C, HIV infection and syphilis (PB);
• A smear to identify mutated cells and microflora;
• On the detection of infectious agents (PCR diagnostics);
• Kolkoskopiyu (internal examination of the organ by means of a kolkoscope).

A month before surgery, the patient is recommended to exclude intimate relationships and observe personal hygiene.

When this procedure is prescribed, many women have the first questions: what is conization of the cervix? How is the operation? Under anesthesia or not?

In fact, such a procedure is performed using local anesthesia, usually a solution of lidocaine and adrenaline at a concentration of 1%. If the patient is allergic to local anesthetics, then a short intravenous anesthesia is used. Therefore, the operation is considered to be painless. The best time for surgery is considered to be the first week after the completion of menstrual flow, as this virtually eliminates pregnancy, and there is a long enough time to delay the wound after the operation.

Conning Technique:

1. Introduction to the vagina of a mirror made of plastic.
2. Treatment of the neck with iodine solution to indicate the boundaries of the affected tissues.
3. Excision of the affected area.
4. Extraction of the excised fragment and its further investigation.
5. Cauterization of bleeding sites.

Usually the manipulation takes 15 minutes.

Contraindications to conization

Conization of the cervix is not performed if there are inflammatory processes in the genitals. In such cases, the operation is transferred to a later period in order to remove the inflammatory diseases.

The procedure is excluded if a cervical oncology was detected in the third or fourth stage during the examination. In this case, there is a risk of spreading cancer cells to neighboring organs. As a result, the vagina, bladder, and rectum can be affected. The reason for this development of events may not be the error of the operating doctor, but the nature and cunning of the tumor itself, which seeks to take root in all parts of the body.

If such a tumor is detected, removal of the entire organ is indicated.

Rehabilitation

Also, many people have questions about the rehabilitation stage after conization of the cervix. How is healing?

A full recovery takes several months. After the procedure, women detect a brownish bloody secret from the genital tract, which has a specific odor. This can last for a month. In addition, pain may be disturbing, bearing a aching, pulling or cramping character. Do not be afraid if the first menstruation will be accompanied by more abundant secretions with the presence of clots - this is the norm.

To exclude unpleasant sensations after manipulation, it is recommended:

• Taking anti-inflammatory and analgesic drugs;
• Abstinence from sexual intimacy until the complete cessation of suppository emissions (2-3 weeks);
• To exclude the introduction of tampons, candles and ointments into the vagina, conducting douching;
• Abstaining from taking a bath, visiting the pool and sauna;
• Limit physical activity;
• Do not be in high temperature (beaches, solarium, near stoves and ovens).

Two weeks after conization, an inspection is necessary to monitor the healing process, as well as to identify and prevent possible consequences.

After three or four months, a coloscopy and cytological check of the genitalia are performed. By this point, the healing process must be completed.

Possible consequences of manipulation

Current surgical methods of conization minimize the development of complications. However, they can not be completely excluded:

1. Development of bleeding.
2. Penetration of infection.
3. Stenosis of the cervical canal (constriction).
4. Violation of the cervix's barrier capacity, which can lead to miscarriage.
5. Change in the properties of mucous secretions from the cervical canal.
6. Decreased fertility.

The appearance of scar after the operation is rare, because the method of electrocoagulation is not applied.

Methods of procedure

Modern medical practice involves the conduction of uterine conization in several ways:

1. Laser. It is the most expensive, but also the most high-tech.
2. Radio wave. The method consists in acting on the affected area with an electric current.
3. Loop. The method has a minimal risk of complications and an acceptable cost.
4. Knife. To date, it is rare, because it has a high probability of developing negative consequences.

Today, the most effective is laser conization, which is considered to be the least traumatic. However, codification using the loop method is the most common, because it perfectly combines an acceptable price with high quality, as evidenced by the reviews of specialists.

The laser method of conization

This method is the most expensive, and therefore, questions arise: what is the laser conization of the cervix? What is the operation and what are its advantages?

The procedure is carried out under short-term general anesthesia with a carbon dioxide laser, which simulates the scalpel technique. Before the surgery, the surgeon exposes the cervix and treats the external genitalia with antiseptic solutions. Under the continuous action of the laser beam, the affected area in the form of a cone is delineated, and a small fragment of a healthy tissue (1-2 mm) is captured. Cauterization of the edges of the wound occurs simultaneously.

The advantages of the method:

• Minimizing pain during and after surgery;
• Prevention of postoperative edema;
• Decrease in bleeding during the healing period;
• The laser destroys microorganisms, therefore the risk of infection of the operating field is reduced;
• Scarring of tissues after the procedure is minimal.

The laser operation is effective, bloodless and aseptic, it can be performed in both inpatient and outpatient settings.

Radiowave method of conization

This method is not highly traumatic and is widely used in surgical practice. How does the cone of the uterus congeal with radio waves? When the section is coagulated, the edges of the incisions are eliminated, and bleeding occurs. The method characterizes the high accuracy of removal of the dysplastic region. And the minimized consequences allow to increase the chances of a favorable outcome of subsequent pregnancies.

Loop electroexcitation method

Answering the question what is the loop conization of the cervix, how this manipulation takes place, it can be noted that the removal of the cone-shaped portion of the dysplastic flesh is accomplished by installing the loop of the electrode on this area. After this, a high-frequency alternating current is sent to the loop through which the excision is performed.

The tissues under this method are insignificantly damaged, and the rehabilitation period proceeds well. The pain syndrome is weak and short-lived. There are practically no bleeding.

Knife-type conization method

It is believed that this method is most traumatic and can have negative consequences. Therefore, today such an operation is rarely carried out. When appointing a procedure such as knife conization of the cervix, how to do the operation with a scalpel, it will be useful to understand.

The procedure is performed using general or regional anesthesia with the introduction of hemostatic medicines, sometimes doctors are bandaging small arteries.

After this, the injured flesh in the form of a cone is separated by means of a scalpel. After excision, the edges of the incision are coagulated with a globular electrode to stop the blood. For this purpose, cotton swabs and hemostatic ointments can also be used.

Is it possible to conceive after manipulation

Having understood what is the conization of the cervix, how the procedure is carried out using various methods, we will consider the issue of preserving the genital function. Experts argue that the use of innovative methods of surgery does not actually reduce a woman's chances of becoming pregnant and bearing a baby. However, between the procedure and pregnancy should be an interval of at least a year. When planning a pregnancy after conization, a woman must:

1. To be surveyed at the gynecologist, the oncologist and the endocrinologist.
2. To hand over a smear for tsitolokicheskogo researches and analyzes for presence of hormones in blood.
3. To make a colposcopy of the cervix and ultrasound of reproductive organs.

It was found that dysplasia, cured by means of conization in the first and second stages, practically does not cause complications in pregnancy. And the third and fourth stages of pathology, combined with other circumstances, increase the risk of miscarriages.

Childbirth after the procedure

In connection with this, the actual question is: how are births after conization of the cervix uteri? The consequence of manipulation may be a decrease in the ability of the organ to stretch, which makes it difficult to open, and often the pregnancy ends with a planned caesarean section.

But also birth can be natural if the observing obstetrician-gynecologist does not see contraindications. In the first year after childbirth it is necessary to undergo an examination at the gynecologist at an interval of 3 months in time to detect a new development of the disease, the risk of which increases after pregnancy.

About what threatens the conization of the cervix, how is the operation, the reviews are very ambiguous. It all depends on the stage at which the disease was detected, from the very illness and from the methods of the procedure. Timely consultation with a doctor helps to identify the signs of diseases in the initial stages, which will entail the removal of fewer tissues, accelerate the healing process and increase the chances of a favorable outcome of pregnancy and childbirth.