When you need expanded volume
Extended conization is performed when the transformation zone is displaced into the canal and is not completely visible during colposcopy, when dysplasia spreads along the canal, when there is a relapse after a previously performed conization, and when a more severe lesion is suspected. The height of the removed cone is greater, which increases the likelihood of complete removal of the lesion within healthy tissue. The downside of a larger volume is the risk of cervical shortening, which is taken into account in women planning a pregnancy: in such cases, pregnancy management requires monitoring the length of the cervix. Histological examination of the resection margins is mandatory.
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.