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Cold Knife Cone Biopsy

Medically reviewed by Last updated on Mar 5, 2023.

What do I need to know about a cold knife cone biopsy?

A cold knife cone biopsy is a procedure to diagnose or treat a lesion on the cervix that may be cancer. A piece of tissue shaped like a cone is removed from the cervix.

Female Reproductive System

How do I prepare for a cold knife cone biopsy?

  • Your healthcare provider will tell you how to prepare. He or she may tell you not to eat or drink anything after midnight before the procedure. Arrange to have someone drive you home from the procedure.
  • Tell your provider if you know or think you are pregnant. A pregnancy test may be done before the procedure. Your provider will tell you if you should have the biopsy during or after your pregnancy.
  • Tell your provider about all your current medicines. He or she will tell you if you need to stop any medicine for the procedure, and when to stop. He or she will tell you which medicines to take or not take on the day of the procedure.
  • Your provider may want to do the procedure right after your menstrual cycle ends. This helps avoid confusion with bleeding after the procedure.
  • Do not have sex or put anything into your vagina for 24 hours before the procedure, or as directed.

What will happen during a cold knife cone biopsy?

  • You may be given regional anesthesia to numb the procedure area. With regional anesthesia, you may feel pushing or pressure, but you should not feel pain. General anesthesia may instead be used to keep you asleep and free from pain. Your healthcare provider will apply a solution to your cervix that will help him or her find the lesion. Absorbable stitches may be used to keep the cervix in a certain position. These stitches also help lessen bleeding after the procedure.
  • Your provider will use tools to remove the lesion and some tissue around it. He or she may also scrape cells off the cervix. The cells are tested for cancer.
  • Any bleeding will be stopped. If stitches are used, your provider may also put packing into the area.

What should I expect after a cold knife cone biopsy?

  • You may have pain or cramping for a couple of weeks. You may also have bleeding or discharge from your vagina.
  • Medicines may be given to prevent or treat pain or a bacterial infection.
  • Packing used during the procedure will pass out of your vagina within a couple of weeks.
  • Your healthcare provider will tell you how you can get the results of the biopsy. If results show you have cervical cancer, or precancer, your provider will help you make decisions about how to treat it. Treatment may include radiation, chemotherapy, targeted therapy, or surgery.

What are the risks of a cold knife cone biopsy?

You may have heavy bleeding during the procedure, or up to 4 weeks after. You may develop a bacterial infection. Your cervix may become too narrow. You may need a procedure to widen it if this happens. The cervix may not stay closed if you become pregnant later. You have a higher risk for preterm delivery if this happens. The risk is highest if your provider had to go deeply into your cervix to get the sample.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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Further information

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