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Conization of the cervix: indications, types and conduct, recovery after

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The purpose of cauterization depends on the phase of the cycle and the urgency of the procedure. There are 3 types of procedures:

  • diathermocoagulation,
  • cryodestruction,
  • laser radio wave therapy.

Diathermocoagulation is carried out on an urgent basis, when there is a high probability of rapid proliferation of polyps and their degeneration into a malignant tumor, and cervical biopsy is often taken to rule out cancer.

Laser radio wave therapy as a low-impact method for the rapid healing of wounds is performed on the 5-7 day of the menstrual cycle, so that the cervix heals before the next menstruation comes.

It is better when moxibustion is performed between the 3rd and the 9th day of the cycle. This is the time when the muscle tissue of the uterus is in a softer, more relaxed state, and its neck is slightly ajar.

It is easier for the gynecologist to view the entire cavity and perform a conization procedure in order to completely remove the modified affected epithelial tissue without leaving its particles. In addition, the doctor during the operation will not affect healthy nearby areas, which means that the healing process in the future will be faster.

The process of conization and its types

There are several types of conization, the most common are the following:

  • loop electroconization,
  • radio wave conization type,
  • laser type biopsy
  • knife type of surgery.

The knife type of surgery due to the high probability of complications after its use is used very rarely.

The laser type of intervention is high-tech and most expensive. Looped conization is a method that has a small percentage of complications with a relatively low cost of intervention.

The optimal time of the operation is the period immediately after the end of the month. This period is preferred due to the fact that it completely eliminates the likelihood of pregnancy and leaves a sufficiently long period for the cervix to heal at the site of the formation of the surgical field.

The loop conization consists of several stages. The main steps are as follows:

  1. Introduction into the vagina of a woman lying in a gynecological chair, a plastic mirror.
  2. Removal of vaginal discharge.
  3. Processing of the surgical field with the help of Lugol's solution.
  4. Anesthesia with the help of injections of an anesthetic composition consisting of 1% of p-ra Lidocaine with adrenaline. Epinephrine is needed to reduce bleeding.
  5. The electrode loop is mounted at a distance of 3-5 mm from the border of the transformation zone. With the help of high frequency ac transmission, a transformation zone is cut to a depth of 5 mm.
  6. The cut tissue is removed with tweezers and sent for examination.
  7. At the last stage, coagulation of bleeding points in the surgical field is performed.

The procedure takes about 15 minutes.

Conization is classified according to the physical factor by which a tissue section is removed:

  • Knife
  • Laser.
  • Cryoconization.
  • Electronization.

In terms of the volume emit:

  1. Economical conization (cone biopsy) - the size of the removed area is not more than 1-1.5 cm.
  2. High conization - with the removal of 2/3 or more of the length of the cervical canal.

Pregnancy and childbirth after conization

For various pathological processes in the cervix in women who have not given birth, or in women who are planning to re-pregnancy, the most benign methods should be chosen, if possible without disrupting the structure of the cervix (erosion coagulation, polypectomy).

It is desirable to plan a pregnancy after conization no earlier than one year after the operation.

As a rule, conization does not affect the ability to conceive. But sometimes in cases of too extensive resection of tissues, repeated conizations, and complicated flow, narrowing of the cervical canal is possible due to the development of adhesions. Then the process of fertilization will be difficult.

But the consequences of conization can have a negative impact on normal pregnancy and natural childbirth much more often than on conception. This is explained by the fact that the operation still somewhat changes the structure of the cervix, it can be shortened, its elasticity may decrease.

Therefore, women who have undergone conization may experience miscarriage before the full term: the cervix simply does not withstand the load, it may unfold early.

Natural delivery is possible for women who have undergone conization. But doctors must be completely sure that the cervix is ​​elastic enough. In practice, the delivery of such women is almost always carried out with a cesarean flow. Obstetricians fear inadequate cervical dilatation during labor.

After operation

After surgery, a woman may experience some discomfort and nagging pain in the lower abdomen. After a procedure, the menstruation of a woman can significantly increase and become more prolonged than before the operating procedures.

In addition, after conization of the cervix is ​​observed the formation of brown secretions, which are the norm in this state of the female body. With the appearance of this type of discharge, you can not worry.

Regardless of the type of operation chosen, a wound surface is formed on the cervix. In the process of conization, the upper layer is destroyed under the influence of a laser, electricity or radio waves. In place of the damaged cells, a scab forms, which eventually leaves.

Women who are faced with the need to make a cervix cervix survive. They are interested in how the operation itself is carried out, how the postoperative period goes. Doctors warn that focusing on the experience of other women is not worth it. Feelings will depend on the following factors:

  • pain threshold
  • cervical conditions,
  • the size of the remote area
  • individual response to anesthesia,
  • features of the operation,
  • the amount of scab formed and the intensity of his discharge.

Patients who underwent ordinary knife conization often complained of intense bleeding, severe pain after surgery. The release of a scab from them was often accompanied by bleeding.

After the knife method, an inelastic scar may remain on the cervix. He does not bother a woman, but can provoke problems during pregnancy and childbirth. Sometimes scars remain even after electric looping. A laser and radio wave procedures, as a rule, do not leave.

Healing for many takes 4-6 weeks. But in some cases the process lasts up to 4 months - the duration depends on the individual ability of the body to regenerate tissues.

If there were no problems during the conization, and the woman adheres to the doctor's recommendations, then the likelihood of complications is minimal. Many patients do not even have blood in the first month, they only have abundant watery discharge. Blood or spotting may occur only when the scab is released.

In the postoperative period, women face the following problems:

  • bleeding within 2-3 weeks after surgery,
  • pain in the lower abdomen, in intensity reminiscent of pain during menstruation,
  • an increase in the amount of bleeding during the discharge of a scab,
  • nasty vaginal discharge.

Pain and an increase in discharge may indicate damage to the cervical tissue and the onset of bleeding. An unpleasant smell appears when a damaged area is damaged by pathogenic microorganisms.

A week after surgery, the scab begins to move away in most patients. This may significantly increase the amount of discharge. For many, they become not only more abundant, but also darker.

Any bleeding after conization of the cervix, lasting several days, is the norm, if their number does not exceed the menstrual standards. On the 4th-5th day, fresh blood is replaced by a “smearing”, which has a brownish tint.

There is a rapid renewal of damaged tissue. Sometimes, on the 7th day after the manipulation, renewal of erythema, which is characterized by large maroon clots, is possible.

Such discharge after conization of the cervix - the norm - so comes the scab formed. It forms on the surface of the damaged tissue from the moment of operation, allowing deeper layers to regenerate.

The scab comes out on its own, after which the bleeding gradually stops. During 2 - 3 weeks daub is noted - this process is the norm.

The normal course of the recovery period passes without heavy bleeding. If the operation was performed with complications, the patient noted a number of symptoms, among which there are unusual discharge. For example:

  • The outflow of blood after the conization of the cervix took place in a normal volume, but after the scab fell off, it stopped. Normally, minor bleeding should continue for 1 to 3 days. Its cessation may indicate improper healing.
  • Scanty discharge, cramping pain in the abdomen, giving to the lumbosacral region, during the coming of the next menstruation. Typical for abnormal constriction (stenosis) of the cervix.
  • Sharp intolerable menstrual pain, cramping pains in the lower abdomen, discharge from the vagina with an unpleasant cheesy smell, cheesy structure and dull color. Evidence of infection in the uterus. In a healthy woman, if pathogenic bacteria enter the uterus, the protective functions of the body do not allow inflammation to develop.

After conization of the uterus, you should carefully monitor the discharge.

Even if there are no severe pains, fever and other symptoms, with an abnormally large amount of blood flowing from the vagina, you should immediately consult a doctor. Normally, this should not be.

If the discharge is a cause for alarm, do not hesitate. It is better to show too much anxiety than not to pay attention to the problem that will initiate a new disease.

Therefore, the main purpose of the operation of conization is the removal of areas in which the mechanism of cancer cell degeneration and the prevention of the development of cervical cancer are already running. The operation performs two tasks: diagnosis and treatment.

Conization is planned immediately after the completion of the next menstruation (1-2 dry days). This is done because, in the first phase of the cycle, the level of estrogens increases, which contribute to the proliferation (enhanced recovery) of the epithelium and faster healing.

Need to prepare in advance. When planning an operation, a gynecological examination, colposcopy are carried out for at least a month, and smears are taken for microflora and cytology.

It may be prescribed ultrasound of the pelvic organs and lymph nodes. If necessary, the doctor can take a biopsy from the most suspicious area.

If an inflammatory process in the vagina is detected, appropriate anti-inflammatory treatment is carried out until the normal smear results are obtained.

2 weeks before the intended operation, tests are assigned:

  • General blood and urine tests.
  • Blood for syphilis.
  • Antibodies to HIV, viral hepatitis B, C.
  • Hemostasiogram.
  • Determination of blood type and Rh factor.
  • Fluorography (during the year).
  • Electrocardiogram.
  • Examination by a therapist.

Confection is not carried out:

  1. In the presence of the inflammatory process in the vagina and cervix.
  2. With biopsy-confirmed invasive cancer.
  3. In acute infectious diseases.
  4. With poorly defined boundaries of the transformation of the epithelium.
  5. If the boundaries of pathology go beyond the technical possibilities of treatment.
  6. With decompensation of chronic diseases (heart failure, hypertension, diabetes, renal and hepatic failure).
  7. Blood clotting disorder.

This operation does not require long-term inpatient treatment. It can be carried out in the conditions of day hospital or inpatient treatment of one day.

After conization, the patient is in the ward for about 2 hours, then she can go home.

As a rule, a few days are marked aching pain in the lower abdomen (similar as during menstruation). Discharge from the vagina after this procedure will be at all. But the number and timing of them may be different. Abundant bleeding should not be. This is usually a transparent serous discharge with blood, or light brown, or smearing. Discharges may have an unpleasant odor.

For some, the cessation of discharge occurs after a week, for some it continues until the next menstruation. The first menstruation after surgery may be more abundant than usual.

Features of the procedure

This is a procedure in which a cone-shaped fragment is removed from the neck. After that, it is sent for histological examination.

There are contraindications for cervix conization:

  • diseases of the female reproductive system with inflammatory or infectious nature,
  • invasive cervical cancer, which is confirmed by the results of histological research.

Cervical conization: indications and contraindications

In the course of surgical intervention, a specialist removes a small cone-shaped portion of the surface of the cervical canal and part of the cervix. Very often, cervical conization is carried out not so much for the purpose of treatment, but rather in order to carry out a histological examination of a tissue fragment obtained as a result of the operation.

As a result of the histological analysis, the presence or absence of cells in the test sample of tissue that are able to degenerate into cancer cells is established. A tissue that has signs of a pathological nature is removed by a single surgical procedure, which is an advantage.

After the surgical intervention and the end of the healing period of the surgical field on the surface of the cervix, you need to visit a doctor and undergo a cytological examination. Very rarely, but it may still be necessary to perform a biopsy again when suspicious cells appear.

There are a number of indications and contraindications for cervical conization. The main indications for surgery are the following:

  • detection of pathological tissue sites on the mucous membrane of the cervical canal,
  • the development of dysplasia of 2-3 degrees in case of confirmation of the diagnosis using histological analysis,
  • upon receipt of negative results of the PAP test, which is a cervical smear test.

A contraindication to conization is the presence of invasive cervical cancer in a woman’s body; in addition, conization cannot be used if infectious ailments of the pelvic organs develop in the body.

Conization is a widely used procedure in gynecology. The purpose of the operation is to remove such elements:

  • tumors in the uterus,
  • erosive sites
  • malignant tumors,
  • tumorous fragments of unknown etiology.

Conization is often carried out to reduce the risk of developing oncology. During the procedure, a biopsy of the cervix is ​​often taken to examine tissue for histology.

Cervical conization is prescribed in such cases:

  • detection of pathological sites in the cervical canal of the cervix,
  • dysplasia 2-3 degrees,
  • according to the results of histological examination,
  • if you suspect the development of cancer, when a cervical biopsy is necessary.

Such an operation is carried out in a loop, laser or radio wave. Almost any of the methods used for cauterization of erosion leads to a delay in menstruation. The procedure is contraindicated in the following cases:

  • in inflammatory processes,
  • with infectious diseases in the genital tract,
  • in case of cervical cancer of the invasive form.

In general, conization takes no more than 20 minutes, does not cause pain due to the absence of nerve endings in the cervix. Anesthesia is not required.

Removal of pathological tissue is done by applying alternating current to the loop and cauterizing erosion. So that in the future there will be no complications and infection of the uterine cavity, the doctor will prescribe a course of antibacterial drugs and vitamins for women to maintain immunity.

Dangerous complications

In most cases, after conization of the cervix uterus painlessly leaves. But some women say that this period is accompanied by the following:

  • there is pain in the lower abdomen,
  • there is discomfort around the cervix,
  • the amount of bleeding increases.

Patients claim that the pain in nature resemble menstrual. They can be nagging and aching. If necessary, Ibuprofen or Ketonal can be taken to alleviate the condition. If there is a cutting, sharp pain, you should consult with your doctor.

Examination by a gynecologist is necessary if the woman has a scab and the following is recorded:

  • the temperature rises
  • начались интенсивные выделения, напоминающие кровотечение,
  • беспокоит сильный зуд.

Dead skin tissues do not always begin to move away painlessly. Cutting pains, accompanied by the appearance of heavy bleeding may indicate damage to the tissues of the cervix.

In this case, the gynecologist should treat the damaged area to stop the bleeding. Thus, the scab should not move away.

Also, women are prescribed antibiotic therapy to prevent complications.

Some feel severe discomfort when the scab leaves. Patients complain of weakness, drowsiness, chills, slight dizziness.

Many people are interested in exactly how the scab leaves after cervical conization. Understand that the process of rejection began, you can, if we consider the selection. In them, women may notice gore in the form of crusts.

Most women have a postoperative period without complications. But sometimes special hemostatic preparations are required. If indicated, the doctor may prescribe:

Independently begin to drink hemostatic drugs without a medical examination can not be. It is possible that the vessel was damaged when the scab departed. Only coagulation can cope with bleeding.

In the standard time after conization in women, menstruation occurs. In the first and second cycle after surgery, menstruation is more abundant, they can last longer than usual. But as a rule, on the 3rd cycle the situation is normalized.

Some women can not understand the nature of the discharge: it is difficult to understand, a scab or menstruation begins. If conization was done on days 5-7, then the crust leaves, respectively, on days 10-17 of the cycle. It is too early to start menstrual flow.

Judging by the patient reviews, it is possible to understand that dead cells are rejected by the nature of the bleeding. Usually in the morning the intensity of discharge is greater, and in the evening they practically stop.

It is considered a norm if serous-bloody discharge occurs during 10-20 days after conization. Periodically, they may increase, recalling the nature and intensity of the menstrual.

You should immediately consult a doctor in the following cases:

  • bleeding is more abundant than normal menstruation,
  • heavy discharge or a lot of clots
  • severe pain in the lower abdomen,
  • increased body temperature
  • discharge with an unpleasant odor continues for more than three weeks after the procedure.

Complications with modern types of conization are rarely observed (1-2%).

  • Bleeding.
  • Accession infection with the development of inflammation.
  • Cicatricial deformity of the cervix.
  • Pregnancy failure (spontaneous abortions and preterm labor).
  • Endometriosis.
  • Violation of the menstrual cycle.

According to reviews of patients who underwent conization:

  1. Do not worry too much - the operation is small, complications are very rare.
  2. The operation itself does not cause discomfort.
  3. The pain after the operation is quite tolerable, it takes 1-2 days.
  4. After the operation, you can go home, but preferably with an accompanying person and by car, since after anesthesia you may feel dizzy.
  5. After surgery, discharge is noted up to 2-4 weeks. This is normal. After discharge of the scab, discharge may increase.
  6. It is necessary to take care in advance that someone from the household will undertake part of the homework, since it is impossible to lift weights and over-exert yourself. This is especially true when there is a small child at home.
  7. It is necessary to trust the doctor and fulfill all restrictions during the month.

When conization is assigned

Conization is carried out with visible pathological areas on the cervix, as well as when cervical epithelium dysplasia is detected in smears that are taken from women annually on medical examinations.

The main conditions under which conization is carried out:

  • The presence of zones of modified epithelium during colposcopy.
  • Identify atypical cells in smears.
  • Dysplasia 2-3 degrees according to the results of morphological research.
  • Erosion.
  • Leukoplakia.
  • Ectropion (inversion).
  • Cervical polyps.
  • Cicatricial deformities of the cervix after ruptures, injuries, previous manipulations on the cervix.
  • Relapse of dysplasia after electrocoagulation, laser vaporization, cryodestruction.

Nevertheless, the main reason why a woman is sent for coniza- tion is cytologically or histologically identified cervical dysplasia. Dysplasia is a violation of the normal differentiation of strata of the multilayer epithelium. It is believed that dysplasia in most cases turns into cancer. In other classifications (especially abroad), the term “cervical intraepithelial neoplasia” (CIN) can be found, in which there are three degrees. Conization is carried out mainly with CIN II.

Purpose of operation

Therefore, the main the purpose of the operation of conization is the removal of areas in which the mechanism of cancer cell degeneration has been launched and the prevention of the development of cervical cancer. The operation performs two tasks: diagnosis and treatment.

  1. A section of the mucous membrane is removed with pathological changes within the unchanged tissue (healthy tissue is grasped in the range of 5-7 mm).
  2. The removed part of the cervix is ​​sent for histopathological examination.
  3. If the study excludes invasive cancer, and the edges of the distant cone do not contain dysplastic changes, the pathology is considered to be radically cured.
  4. If the study raises doubts about the incomplete removal of the dysplasia zone or the presence of invasive cancer, conization is considered a diagnostic step. In this case, another more radical treatment is planned.

Preparation for surgery

Conization is planned immediately after the completion of the next menstruation (1-2 dry days). This is done because, in the first phase of the cycle, the level of estrogens increases, which contribute to the proliferation (enhanced recovery) of the epithelium and faster healing.

Need to prepare in advance. When planning an operation, a gynecological examination, colposcopy are carried out for at least a month, and smears are taken for microflora and cytology.

It may be prescribed ultrasound of the pelvic organs and lymph nodes. If necessary, the doctor can take a biopsy from the most suspicious area.

If an inflammatory process in the vagina is detected, appropriate anti-inflammatory treatment is carried out until the normal smear results are obtained.

2 weeks before the intended operation, tests are assigned:

  • General blood and urine tests.
  • Blood for syphilis.
  • Antibodies to HIV, viral hepatitis B, C.
  • Hemostasiogram.
  • Determination of blood type and Rh factor.
  • Fluorography (during the year).
  • Electrocardiogram.
  • Examination by a therapist.

Confection is not carried out:

  1. In the presence of the inflammatory process in the vagina and cervix.
  2. With biopsy-confirmed invasive cancer.
  3. In acute infectious diseases.
  4. With poorly defined boundaries of the transformation of the epithelium.
  5. If the boundaries of pathology go beyond the technical possibilities of treatment.
  6. With decompensation of chronic diseases (heart failure, hypertension, diabetes, renal and hepatic failure).
  7. Blood clotting disorder.

What are the types of conization

Conization is classified according to the physical factor by which a tissue section is removed:

  • Knife
  • Laser.
  • Cryoconization.
  • Electronization.

In terms of the volume emit:

  1. Economical conization (cone biopsy) - the size of the removed area is not more than 1-1.5 cm.
  2. High conization - with the removal of 2/3 or more of the length of the cervical canal.

Knife conization of the cervix

The area of ​​the cervix is ​​cut with a normal scalpel. Until the 1980s, staple conization was the main method for obtaining diagnostic material when atypia was detected in smears.

Currently very rare due to the high frequency of complications. (bleeding, perforation, formation of rough scars after surgery). Complications after knife conization are noted in 10% of cases (with other more modern methods - 1-2%).

However, it is precisely knife conization that makes it possible to obtain a drug for research of a better quality than with laser or electron-wave removal. Therefore, this type of conization is still used in a number of clinics.

Laser conization of the cervix

The desired area is removed by exposure to a high-intensity laser beam. The operation is low-impact, almost bloodless and painless.

Advantages of laser conization:

laser cervization of the cervix

It allows to dose the depth of destruction with high accuracy.

  • It is possible to conduct conization with extensive lesions and the spread of the transformation zone on the vagina.
  • May be carried out with cervical deformities.
  • The laser also has a sterilizing effect, so there is less risk of infection.
  • Conducted simultaneous coagulation of blood vessels.
  • disadvantages:

    1. There is a risk of burning surrounding healthy tissue.
    2. In most cases, general anesthesia is required for maximum immobilization (the patient should not move).
    3. The method is quite expensive.

    Radio wave conization of the cervix

    Other terms: electroconization, electrowave conization, diathermoelectroconization.

    For these purposes, the apparatus of radio wave surgery "Surgitron". It is a generator and a set of different electrodes.

    The destruction of tissues is achieved by exposure to high-frequency alternating current.

    An even more advanced method of radio wave conization is radiosurgical loop excision.

    radio wave conization of the cervix

    The necessary area is cut out with a loop electrode specially developed for this purpose.

    The doctor chooses an electrode with a loop of the desired size (the section to be removed must be 3-4 mm larger than the size of the nidus). A high-frequency current is applied to the electrode. By rotating the loop electrode in a circle, a neck section is cut to a depth of 5-8 mm.

    Advantages of the method:

    • May be performed under local anesthesia.
    • Damaged blood vessels immediately coagulate - the risk of bleeding is minimal.
    • The temperature in the zone of destruction does not exceed 45-55 degrees. There is no risk of getting burned by the surrounding healthy tissue.
    • Allows you to take a piece of tissue for research less damaged than with the laser method.
    • A very small percentage of complications.

    Today this method of conization is the most common.

    Cryoconization

    By the effects of the freezing effect of nitric oxide, the pathological focus is destroyed. The method is painless and fairly inexpensive. In our country at the present time is practically not used. It is believed that it is not always possible to accurately calculate the power of the freezing factor, and also the main goal of conization is not fulfilled - there is no part of tissue to be investigated.

    How is the operation conizatsii

    This operation does not require long-term inpatient treatment. It can be carried out in a day hospital or inpatient day setting.

    Special training is also not required. It is recommended to shave the hair in the pubic area, eat nothing in the morning and go to the toilet (empty the intestines and bladder).

    1. The operation is performed under local anesthesia with possible prior sedation with tranquilizers, or under short-term intravenous anesthesia.

    2. Position - in the gynecological chair.
    3. The doctor examines the cervix in the mirrors.
    4. A test is carried out with a solution of Lugol or 3% solution of acetic acid: when treated with a solution of iodine, healthy tissue becomes yellow, and the modified epithelium remains unpainted. When treating with acetic acid, the pathological area acquires a whitish color.
    5. The cervix is ​​infiltrated with a solution of novocaine or lidocaine.
    6. Next is the conization procedure itself, depending on the method chosen. A section of the mucous is removed in the form of a cone with the apex facing the cervical canal. Electrodes are installed within 3-5 mm from the boundaries of the transformation zone. The thickness of the section to be cut is about 5 mm.
    7. Using tweezers, the cut piece is removed and sent to the study.
    8. Coagulating blood vessels.

    The whole operation takes no more than 20 minutes of time.

    Main limitations

    The cervix after conization is an open wound. Therefore, as for the healing of any wound, it is necessary to minimize the effects on it. Namely:

    • Do not have vaginal sex during the month.
    • Do not use vaginal tampons.
    • Do not take a bath (wash in the shower).
    • Do not lift more than 3 kg.
    • Excluded bath and sauna.
    • Do not swim.
    • Avoid overheating.
    • Do not take drugs that prevent blood clotting (aspirin).

    How is neck healing?

    With an uncomplicated postoperative course, cervical healing occurs fairly quickly. Approximately on the 7-10th day, the scab covering the wound after vascular coagulation begins, and the epithelization of the wound begins. Complete healing occurs by 3-4 months.

    Usually at this time and repeated examination by a gynecologist. If a woman doubts that something is going wrong, she should consult a doctor before. Usually these moments are always negotiated, and the patient knows about suspicious symptomx:

    1. Abundant spotting, as with menstruation
    2. Increased body temperature.
    3. Ongoing discharge for more than 4 weeks or no reduction in discharge by the 3rd week.
    4. Burning and itching in the vagina.
    5. The appearance of pain in the lower abdomen after some time after surgery (pain for several days immediately after conization is normal).
    6. The appearance of discharge after the "dry" period.

    As a rule, no additional effects on the neck are required in this period. But in some cases douches or candles can be prescribed.

    A cytology smear should be taken 3-4 months after the operation and thereafter every six months for 3 years. If atypical cells are not detected, after 3 years, you can undergo a routine screening once a year.

    Possible complications

    Complications with modern types of conization are rarely observed (1-2%).

    • Bleeding
    • Accession infection with the development of inflammation.
    • Cicatricial deformity of the cervix.
    • Pregnancy failure (spontaneous abortions and preterm labor).
    • Endometriosis.
    • Violation of the menstrual cycle.

    Pregnancy after conization

    For various pathological processes in the cervix in women who have not given birth, or in women who are planning to re-pregnancy, the most benign methods should be chosen, if possible without disrupting the structure of the cervix (erosion coagulation, polypectomy).

    But if stage 2-3 dysplasia is histologically confirmed, conization is inevitable in this case. At the same time, modern methods are chosen (laser and radio wave conization), the risk of complications is minimal.

    It is desirable to plan a pregnancy after conization no earlier than one year after the operation.

    As a rule, conization does not affect the ability to conceive. But sometimes in cases of too extensive resection of tissues, repeated conizations, and complicated flow, narrowing of the cervical canal is possible due to the development of adhesions. Then the process of fertilization will be difficult.

    But the consequences of conization can have a negative impact on normal pregnancy and natural childbirth much more often than on conception. This is explained by the fact that the operation still somewhat changes the structure of the cervix, it can be shortened, its elasticity may decrease. Therefore, women who have undergone conization may experience miscarriage before the full term: the cervix simply does not withstand the load, it may unfold early.

    Natural delivery is possible for women who have undergone conization. But doctors must be completely sure that the cervix is ​​elastic enough. In practice, the delivery of such women is almost always carried out with a cesarean flow. Obstetricians fear inadequate cervical dilatation during labor.

    According to reviews of patients who underwent conization:

    1. Do not worry too much - the operation is small, complications are very rare.
    2. The operation itself does not cause discomfort.
    3. The pain after the operation is quite tolerable, it takes 1-2 days.
    4. After the operation, you can go home, but preferably with an accompanying person and by car, since after anesthesia you may feel dizzy.
    5. After surgery, discharge is noted up to 2-4 weeks. This is normal. After discharge of the scab, discharge may increase.
    6. It is necessary to take care in advance that someone from the household will undertake part of the homework, since it is impossible to lift weights and over-exert yourself. This is especially true when there is a small child at home.
    7. It is necessary to trust the doctor and fulfill all restrictions during the month.

    Depends on the selected method. The price varies from 10 to 40 thousand rubles.

    Novostrueva Irina Vladimirovna

    Psychologist, Emotionally-shaped therapist. Specialist from the website b17.ru

    I made a conization in December, I will not leave either. I, too, always had a clear cycle, the monthly periods were 7 days each. And now before the monthly for 7-10 days daub. As a result, I have blood on a month from 14 to 17 days. I am so tired. Yesterday I was at the doctor, did a colposcopy, everything is within the normal range, she passed the tests, they will be ready on Wednesday-Thursday, they called for an ultrasound scan by the end of the month.

    I am observed in the clinic 31+, in the same place I made conization in December at Kappusheva L.M.

    Good afternoon! They made a cervix cervix in April of this year, it was cr in citu. The day was still in the hospital to avoid possible bleeding.There were no problems after the operation. Then I was watched in May, June (every month). She didn’t sunbathe, didn’t bathe until the doctor resolved. In July she was on vacation for a week, the climate didn’t change dramatically, but there was a lot of stress, travels and a little sleep. Although the last 2 years I have a regular cycle, come on a daily basis. Usually I have very strong pains on the 1st day, I have enough 1 painkiller pill. This time there were very strong pains, giving along the entire length of the legs, 2 nights saw the tablets, because the pain did not allow to fall asleep. The pains are like they put you on a stake. Menstruation was more scarce than usual, although the doctor on the contrary warned that they could be very strong. At the end of the menstrual period - brown discharge, I don’t remember when the last time was brown discharge, until conization, there were no problems with the cycle. In August, HPV did 15 types of quantitative screening, all by zero, HPV was not detected. Before that I had 33 type. Last month constantly pulling / aching discomfort. Not even pain, I just feel the neck. It is as if menstruation should begin, but they do not begin. I read that after conization there can be a complication in the form of a narrowing of the cervical canal, because of this it will be bad to go monthly and it will be necessary to do a bougienage of the canal. If there are similar problems - then the gynecologist will see it on examination? Girls, who made conization, did someone have similar problems? Where are observed after conization w / m in Moscow?

    Bullshit you have some. I think this is not a matter of conization. I do not see any connection with menstruation. I am not a doctor, but I’ve been living with gynecologists for the last 5 years. I was given conization in 2012, I had sex before I needed to do it, so it became bleeding. Immediately to the gynecologist, I was given some candles for healing, and everything went fine. If for some reason your gynecologist, you are not “reassured,” go to another. In the same place, they immediately see that with the cervix, this is not the uterine cavity. When they look at me now, they say that it is clear that conization has been made.

    Go to a good clinic.
    I just made conization in the Research Institute. Kulakov on Oparin, 4. There are brilliant doctors led by L. Adamyan. Although it is all individual, of course.

    But everything went well for me ... I don’t even know what to advise you ... but I want to help. When you to the gynecologist? Pass the tests there, suddenly something messed up. And ask your doctor about Depantol, maybe in your case too, you just need to heal everything there. As you know, I had these candles. And I say - everything went well and healed, then no ailments. Good luck to you

    Spotting after cauterization of erosion

    Usually, a gentle daub goes on the 9-10 day after cauterization, scanty discharge from the vagina. Since the term they appear just before the month, women often confuse them with the arrival of menstruation. However, rather, these are bruises that appear for a completely natural reason, due to healing.

    A little later, watery serous discharges often begin to recede with an unpleasant putrid odor. The uterus is injured and at the time of healing of erosive areas any insignificant influence, for example, lifting weights or having sex, can lead to the following consequences: discharge of secretions from blood clots.

    The possible reason for the appearance of discharge is cicatrization of the areas exposed to the mechanical impact or rejection of the scab (separation of the dry crust at the site of erosion), so doctors strongly recommend women to protect their health for at least 3-4 weeks after the operation. The following should be avoided:

    • sexual intercourse
    • physical training
    • weight lifting
    • nerve strain.

    Discharges are a natural reaction of the uterus to a burn, and this should not be cause for concern.

    Why there is a delay after cauterization of cervical erosion

    The delay of menstruation may well be after cauterization erosive area. This mini-operation leads to the fact that the menstrual cycle gets off, but women should not worry, especially those who are closely watching the arrival of each menstruation and start to panic if it has not started on the appointed date.

    After 1.5-2 months, everything should be normalized. The second uterine cycle will begin without delay.

    The uterine receptor apparatus reacts negatively to the mechanical effects of medical equipment during the procedure, which often leads to a delay. In addition, delayed menstruation may be caused by trauma to the epithelial layer of the uterus, obtained during cauterization. Or the banal stress, women's feelings for their health and the effectiveness of the procedure can serve as the cause.

    Monthly after cauterization came earlier

    Cauterization of erosion leads to discharge of blood clots, serous secretions. The uterus is injured, and the formed scab after healing of the erosive area should sooner or later come out. Factor provocateur early his office is lifting weights or having sex with women immediately after the operation, when the uterus has not yet healed, and the resulting crust on the site of the removed papule did not have time to dry well.

    Menstruation may come prematurely with soreness in the stomach and lower back due to the defeat of healthy epithelial cells under the influence of hardware.

    In addition, as a result of the intervention, a narrowing of the lumen in the cervix sometimes occurs, which makes it difficult for a timely exit of accumulated blood. She begins to flow out gradually, which is often mistaken for the beginning of menstruation. The condition becomes dangerous, because bacteria multiply in the secretions, causing inflammation, and requires elimination by repeated surgery.

    Monthly after conization of the cervix

    White or clear discharge with a small amount of blood is normal after cauterization. They will go anyway due to injury of the uterus and can not stop until 2-3 weeks after conization, until the wounds heal completely.

    It is even possible to leave fetid brown blood spots, and this is the norm at the time of scab discharge. Such strange discharge can be observed for quite a long time and in different volumes.

    Monthly after conization of the cervix should come on time if the operation was performed by a doctor with high quality and in full. The first will be more abundant, painful and long, the next should go, as usual, and on time. Women are also encouraged to stock up on sanitary pads in case of the arrival of heavy periods.

    You should not worry if there is a delay for several days, then everything should be normalized. Bleeding the uterus after conization may even month. It all depends on the vastness of the area that is subject to cautery. If you are worried about severe abdominal pain, then you can drink Diclofenac, Ibuprofen.

    After conization, liquid discharges with blood impurities will begin to flow away, but this, of course, is not monthly. During the first 15-25 days after the procedure, this is normal.

    Indications for conization of the cervix

    Conization is a widely used procedure in gynecology. The purpose of the operation is to remove such elements:

    • tumors in the uterus,
    • erosive sites
    • malignant tumors,
    • tumor fragments of unknown etiology.

    Conization is often carried out to reduce the risk of developing oncology. During the procedure, a biopsy of the cervix is ​​often taken to examine tissue for histology.

    Cervical conization is prescribed in such cases:

    • detection of pathological sites in the cervical canal of the cervix,
    • dysplasia 2-3 degrees,
    • according to the results of histological examination,
    • if you suspect the development of cancer, when a cervical biopsy is necessary.

    Such an operation is carried out in a loop, laser or radio wave. Almost any of the methods used for cauterization of erosion leads to a delay in menstruation. The procedure is contraindicated in the following cases:

    • in inflammatory processes,
    • with infectious diseases in the genital tract,
    • in case of cervical cancer of the invasive form.

    In general, conization takes no more than 20 minutes, does not cause pain due to the absence of nerve endings in the cervix. Anesthesia is not required.

    Removal of pathological tissue is done by applying alternating current to the loop and cauterizing erosion. So that in the future there will be no complications and infection of the uterine cavity, the doctor will prescribe a course of antibacterial drugs and vitamins for women to maintain immunity.

    Conization: essence

    Cervical conization is a fairly common gynecological procedure, which is carried out, if necessary, to remove a portion of the uterus affected by the disease.

    Until the operation is carried out, the tumor can remain for a long time and develop in the area of ​​the cervix. Only after the doctors confirm their suspicion of the presence of erosion, dysplasia, uterine tumors of a malignant nature, the question of the removal of the affected uterine region immediately becomes.

    After a fragment of the tumor is removed, to eliminate all possible risks, it is sent to the laboratory for research. If it is discovered that it is a malignant tumor, then appropriate treatment measures are taken. If this information is not confirmed, the woman simply undergoes a course of recovery after surgery.

    There are a number of contraindications for this operation:

    • inflammatory processes
    • infectious diseases that occur in the genital tract
    • with invasive cervical cancer.

    The duration of the procedure takes from 20 minutes to one hour. A local type of anesthesia is performed, since the cervix has virtually no nerve endings, so there is no need for general anesthesia. Pathological tissues are removed by using an electrode loop, where alternating current is directed.

    In order to exclude infectious diseases, a woman in the postoperative period is prescribed a number of fortifying drugs and antibacterial complexes.

    Consequences of cervical conization

    Menstruation after surgery will be much more abundant and longer than before.

    After the operation is performed, the woman may experience nagging pain in the lower abdomen.

    Monthly after conization of the cervix, as a rule, come at a time when they should. But menstruation after surgery will be much more abundant and longer than before. There may be discharge from the vagina brown, but these are all typical consequences and do not worry about it.

    After surgery, a few days can keep the body temperature high.

    In rare cases, there may be such a complication as bleeding, but it occurs only in 2% of women who have undergone the conization process. When bleeding and pain in the lower abdomen is necessary, as soon as possible seek the help of a specialist.

    Postoperative period

    Conization has no effect on the process of conception, however, the process of gestation itself and the delivery may undergo some changes.

    In the first few days after the operation, the woman will feel pain in the uterus, as during the menstrual cycle. There may be a small bloody vaginal discharge, but this is normal during the healing period.

    After 7 to 9 days after surgery, the scab separates. At this time, blood discharge increases somewhat. In the event that bleeding begins, which does not stop for several days, it is necessary to urgently consult a doctor.

    Also, a signal to consult a specialist is vaginal discharge, which does not stop for a month.

    3-4 months after the operation, complete healing occurs, the uterus no longer bleeds.

    During the first month after surgery you can not:

    • drinking alcohol
    • have sex
    • take drugs that dilate blood vessels
    • go to the sauna or bath, as well as a hot bath
    • lift heavy objects.

    As soon as the woman begins her period after conization of the cervix, it is necessary to use only sanitary pads.

    The first couple of months you can not use tampons, so as not to damage the healed uterus.

    Conization is a fairly common surgical intervention in the field of modern gynecology. It allows you to remove a part of the affected tissues, without any consequences and with full preservation of the fertility function of the woman. Monthly after conization come as soon as the body is ready for it.

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    Cervical conization: consequences

    Most often, after the operation, the woman is concerned about pain in the lower abdomen of a pulling nature. Similar symptoms can last up to 2 to 3 weeks. Experts recommend their patients to take painkillers at this time.

    As for the onset of regular menstruation, the surgical intervention does not affect their sequence. Menstrual bleeding usually occurs at the appropriate time, but their intensity is more pronounced. Many women are forced during this period to take iron supplements to compensate for blood loss.

    Such manifestations should not frighten patients, however, in the presence of severe bleeding should consult a doctor. An abundant discharge of blood during the first menstrual periods after surgery can usually be found in 3% of women, but caution in this case will not interfere.

    Conization of the cervix

    Brief description of the diathermoelectroconization method

    This method of treatment of the female genital pathology takes the second place in the total number of operations performed for this group of patients. In modern clinics for surgical intervention in such an intimate and tender place, a special electrode is used - a European-standard conizer, modified by an obstetrician-gynecologist Rogovenko S.

    The essence of this treatment method is that with the help of this electric knife, the damaged tissues of the cervix are excised by a section in the form of a cone, with the sharp side usually facing the inside of the uterine cavity. The resulting stump coagulates, in its place a scab forms, which after some time disappears.

    It depends on the depth of tissue damage by the electrode and the speed of the death of coagulated tissues when the first menses after conization of the cervix begin.

    Diathermoelectroconization is widely used for the differential diagnosis of pathology in the vagina and cervix. With the help of electrodes, a so-called conizational biopsy is carried out, which, thanks to the morphological picture of the layer-by-layer section of the cervical tissue, allows you to make a definitive diagnosis and prescribe appropriate therapy to the sick woman.

    It is not necessary to go into all the technical details of the DEE in patients, since such things are interesting, mostly only to specialists. It should be noted that this operation is performed without anesthesia; in rare cases, local administration of novocaine or bupivocaine is recommended.

    Features of the early postoperative period in such patients

    For 10–15 days after conization, women usually complain to their attending physician about heavy bleeding from the vagina. A similar pattern can be maintained until the scab is completely rejected from the vaginal cavity.

    The doctor must warn the patient before the manipulation that the abundant periods after conization of the cervix should not frighten her. So the patient reacts to surgery. Over time, if there are no complications, the volume of menstrual blood will gradually return to the usual pre-operative rate.

    See the video on the procedure:

    Early postoperative problems

    The time period for the development of violations by the female genital organs associated with postponed conization is 3–5 months from the date of the operation. Most often, this includes various bleeding from the vagina with the intervention or as a result of early rejection of the scab.

    This cohort of patients may develop an inflammatory process in the area of ​​the uterus and appendages. Similar complications occur in 1–3% of operated women.

    Openings with the menstrual cycle are most often simply provoked by the operation performed, however, experts refer to hyperpolymenorrhea and various acyclic hemorrhages to the consequences of cervical excision. If a woman's menstrual period after conization of the cervix began earlier, then most often this is a consequence of the manipulation.

    Late complications in patients undergoing diathermoelectroconization

    If after the operation more than 6 months have passed, doctors usually talk about the late complications of this medical procedure. These include:

    • The shortening of the length of the cervix, accompanied by prolapse of the mucous membrane of the cervical canal.
    • In 5–7% of cases, patients after a similar operation develop a sharp narrowing of the cervical canal. Подобная патология требует проведения оперативного увеличения диаметра специальными расширителями. Это необходимо для нормализации выделения крови из матки в период менструации.
    • Возможны воспалительные процессы, возникшие на месте операции. Endometriosis of the cervix and pseudo-erosion of this area is distinguished. Similar pathology was described in 12 to 18% of patients after conization.

    There are a large number of long-term effects of such manipulation, but this is a topic for a separate conversation. We only note that different variants of the ovarian-menstrual cycle disorder are possible in every 6 women who have undergone DEE.

    Features of menstruation after such operations

    In addition to various complications associated with the development of the inflammatory process in the area of ​​the operation, many patients are concerned about possible menstrual abnormalities in the postoperative period. Most often, such problems occur in the first 2 - 3 months after surgery.

    When a woman began menstruating after conization of the cervix, she will definitely pay attention to their excessive profusion. This is due to the restructuring of the hormonal system and the local hemostatic reactions of its body.

    After rejection of the scab for 2 - 3 months, the patient undergoes a process of epithelialization after excision of the cervix. The length of the time of menstrual disorders depends on the duration of the recovery period.

    In the long-term period, difficulties during menstruation may arise if the cervix sharply decreases in diameter as a result of postoperative spasm. Menstrual blood does not get enough out of the uterus and can lead to the development of the inflammatory process. To prevent such complications, experts resort to bougienage of the cervical canal.

    According to modern medical statistics, problems with menstruation after such operations are recorded in 20% of patients, while it is noted that these disorders, as a rule, are temporary.

    Bleeding treatment

    If the patient develops early bleeding after the conization, the actions of health workers depend on its strength and duration. Excessive bleeding requires additional hemostasis with the help of DEK with minimal current or various local hemostatic procedures.

    Good help with such problems swabs with hydrogen peroxide, adrenaline or aminocaproic acid. A 3% warm solution of hydrogen peroxide is also recommended in the form of baths; cauterization of the bleeding surface with potassium permanganate is indicated.

    If there is a need, it is possible to promptly stop the bleeding. In this case, the cervix is ​​stitched or coagulated with a laser.

    Abundant periods, arising after such a manipulation, in most cases do not require specific treatment, as they are temporary and functional. If there is a risk of a critical drop in red blood counts, appropriate symptomatic therapy is carried out.

    We recommend reading an article on cervical dysplasia. From it you will learn about the causes of pathology and its diagnosis, methods of treatment, the effectiveness of conservative and surgical treatment, as well as the restoration of the body after treatment.

    As mentioned above, menstrual disorder after cervical conization occurs in only 20% of patients. According to this indicator, diathermoelectroconization is one of the most benign methods of treating pathological changes in the tissues and cells of this problematic organ in most women. However, with prolonged menstruation, as well as other alarming symptoms, it is better to consult a doctor.

    What is this procedure and in what cases it is necessary

    As a result of infectious and inflammatory diseases of the urogenital system, hormonal disruptions and other pathological processes in a woman’s body, a part of the epithelium in the lower uterine segment undergoes atypical changes. This condition requires careful attention, since in some cases, in the absence of proper treatment, the transformation area can not only increase in size, but also develop into a cancerous tumor.

    In order to avoid negative consequences, modern medicine proposes to remove atypical cells, which reduces the risk of increasing the area of ​​the pathology and facilitates its diagnosis.

    There are the following indications for cervical conization:

    • diagnosis of transformation zones on colposcopy,
    • erosion,
    • leukoplakia,
    • dysplasia 2 and 3 degrees,
    • polyps
    • defects and scars on the neck that prevent conception and carrying a child,
    • recurrence of pathology after other methods of removing the affected area.

    But also this procedure has a number of contraindications:

    • inflammation in the pelvic organs,
    • invasive cervical cancer,
    • fuzzy boundaries of pathological education,
    • chronic diseases: heart or kidney failure, diabetes,
    • low blood coagulation.

    Types of cervical conization

    After the preparatory measures and examination of the patient, the specialist will suggest several methods for eliminating the atypical mucosal area:

    • excision with a scalpel knife
    • electroconization,
    • cryoconization,
    • laser removal
    • radio wave surgery.

    In this case, the choice of method is influenced by a large number of factors, including the patient's physical condition, the size of the atypical site and the equipment of the medical institution, since not every clinic can afford to have expensive equipment in its arsenal.

    In our country, the most common method of conization in public hospitals is to remove part of the neck. using current or electroconization. In most cases, after carrying out such a procedure, the disease recurs. But also a negative consequence of this method is the formation of a rough scar, which negatively affects the reproductive function due to the fact that the neck loses its elasticity and becomes incapable of disclosure. For this reason electroconization, as well as surgical excision, does not apply to non-giving women. Another disadvantage of the method is the risk of opening bleeding during a scab discharge or as a result of physical exertion in the period after surgery.

    Cryoconization method based on the use of low temperatures on the area of ​​the mucous membrane, resulting in necrosis of the atypical zone. Unlike the first methods, it has several advantages: the risk of opening bleeding is minimized, there is no pain during the procedure. Liquid nitrogen is used as a cryoagent.

    Laser removal is carried out with the help of a high-energy beam, under the influence of which the abnormal cells are evaporated, cauterized or removed. Unlike radical methods of conization, this method is less traumatic, however, just as with the first two types of interventions, a scab forms on the neck. Because of the high pain for the procedure using general anesthesia.

    The most effective way to remove the pathology is considered radio wave conization cervix. During this procedure, atypical tissues are exposed to high-frequency current. Under his influence, the cells that form the pathology zone die. Unlike electroconization, such a procedure is carried out using a higher frequency current, which helps prevent damage to nearby tissues and significantly reduces the time of the procedure.

    Features of the postoperative period

    After such an intervention in the life of a woman there are minor changes:

    1. To eliminate the risk of complications, the patient is strongly recommended refrain from sex and exercise within a month.
    2. You can not overheat the body while taking a bath or hot shower, as this can cause bleeding.
    3. In the first menstruation as hygienic means allowed use of gaskets only, because the stagnation of the discharge can cause inflammation in the vagina.

    The period of wound healing is about 3-4 weeks and ends with the discharge of a scab. At this time, the patient may experience discomfort in the intimate area and detect a small amount of dark discharge in underwear.

    How does conization affect childbearing

    Since, as a result of the manipulations, a part of the neck is removed, in subsequent pregnancies cervical insufficiency may develop (pathological shortening of the body and its premature disclosure). This complication of pregnancy implies neck stitching or installation of a special obstetric device - pessary.

    Even if the period of carrying a child passed without complications, the neck that has lost its elasticity will not be able to open enough, therefore conization is one of the indications for planned caesarean section.

    Features of menstruation after conization of the cervix

    At the conclusion of such an intervention in the reproductive system, a number of women note failure of the menstrual cycle. So the body reacts to the changes. It usually recovers in 2-3 months after surgery.

    During the first menstruation is celebrated. having more fluid, because during this period there is an intensive restoration of hormonal background and the regeneration of damaged tissues.

    If, however, due to the narrowing of the cervical canal, the menstrual blood does not come out properly, then the patient should immediately consult a gynecologist, since stagnation of the liquid can provoke inflammation.

    Conclusion

    Women's health needs a special regard. If doctors insist on cervical conization, do not refuse, because complications after any structural changes in this part of the reproductive system can lead to the development of a cancer and, as a consequence, the complete removal of this organ.

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