What is a Cone Biopsy?
A cone biopsy is an extended form of a cervical biopsy, in which a cone-shaped wedge of tissue is removed from the cervix, and then examined under a microscope. The purpose of a cone biopsy is to remove abnormal tissue that may be high in the cervical canal. A small amount of normal tissue around the cone-shaped cut is also taken out, so that the cervix may have a margin of room without abnormal cells.

How is a Cone Biopsy performed?
Usually, a cone biopsy can be a simple outpatient procedure, which means you do not have to stay overnight at the hospital. Prior to the procedure, you will need to disrobe below the waist and drape a piece of cloth over your waist. Then, you will lie down on your back on an examination table, with your feet in a raised set of stirrups. Your doctor will then insert a speculum (curved, bladed instrument) into your vagina, which will gently spread apart the vagina walls, allowing the cervix to be viewed. General anesthesia may be used to make the genital area numb. Regional anesthesia may be used as well.

A cone biopsy procedure may be done using LEEP. It involves an injected medication that numbs the cervix, called a cervical block. If this method is used, your doctor may give you oral pain medication, or an intravenous (IV).

After the procedure
After a cone biopsy is done, a few side effects may be noticed, such as vaginal bleeding or vaginal spotting. Instead of tampons, use sanitary napkins, for about three weeks after the procedure. Sexual intercourse should be avoided, as well as douching, for three weeks as well. Most women are able to return to normal activity within one week. If you experience a fever, heavy bleeding (more than your usual amount during a menstrual period), bad odours or yellow vaginal discharge, or increasing pelvic pain, you should call your doctor immediately.

Why a Cone Biopsy?
A cone biopsy is done primarily because a Pap smear's test results indicates moderate to severe cell changes. A cone biopsy can be used to determine the depth, extent, and severity of the abnormal tissue, and assist in treatment options and decisions.

What are the risks?
A small percentage of women (less than 10%) need blood backing or a transfusion due to increased bleeding. A rare case of a narrowing of the cervix, called cervical stenosis, may occur, but is rare. Another rare case, called incompetent cervix, is where the cervix is unable to remain closed during pregnancy, which would cause a pregnancy to end in a miscarriage or premature labor, and may be a risk after a cone biopsy.