When is conization performed?
The main indication is moderate to severe cervical dysplasia (CIN II–III), confirmed by cytology and biopsy. The method solves two problems at the same time: it removes the pathological area and provides complete material for histological examination - in contrast to a point biopsy, which may not capture the most changed area. The procedure is performed using an electric loop or radio wave method under local anesthesia and takes 15–30 minutes. Healing lasts 4–6 weeks, during which sexual rest is required. Further observation with cytology and HPV testing is mandatory: conization removes the lesion, but does not eliminate the virus.
Cervical pathology: why it is important to treat
Changes in the cervix are asymptomatic for a long time. Moreover, this is where one of the few types of cancer develops that can be completely prevented, provided that precancerous conditions are detected and treated in a timely manner.
The human papillomavirus plays a key role: oncogenic types of HPV cause dysplasia, which, if left untreated, can turn into cancer over the years. Therefore, the modern approach is based on the combination of “cytology + HPV test + colposcopy”, and treatment is prescribed according to the results, and not “by eye”.
Key interventions
- coagulation - destruction of the superficial pathological area
- conization - excision of a cone-shaped section of the neck with capture of the canal
- extended conization - larger volume when the process spreads into the canal
- removal of condylomas and papillomas with HPV infection
Histology is required
During conization, the removed tissue is necessarily sent for histological examination. It shows the true extent of the changes - often more pronounced than according to the biopsy - and confirms that the pathological area has been removed within healthy tissue. Further surveillance tactics depend on this.