What is Conization (LEEP)? How is the procedure performed and why is it necessary?
Conization is a surgical procedure performed to treat or examine abnormal cellular changes in the cervix (cervix). The technique called LEEP (Loop Electrosurgical Excision Procedure) is one of the most commonly used methods of this procedure. Conization removes abnormal cells in the cervix and treats possible pre-cancerous conditions.
What is Conization?
Conization is a surgical procedure in which a cone-shaped part of the cervix is removed. This procedure is used to detect or treat abnormal cellular changes in the cervix. The removed tissue piece is usually examined in the laboratory for biopsy and helps in the early diagnosis of possible pre-cancerous conditions.
LEEP (Loop Electrosurgical Excision Procedure) is one of the most commonly used methods of conization. In this technique, abnormal cells are removed with an electric current using a thin wire loop. LEEP is an effective method used for both diagnosis and treatment.
Why is Conization Performed?
Conization is usually performed to detect and treat abnormal cellular changes in the cervix. When abnormal results are detected in the smear test, doctors may recommend conization to understand whether these cellular changes are pre-cancerous. Conization is also frequently applied in cases of cervical dysplasia resulting from HPV infections.
Conditions Requiring Conization:
- Abnormal Smear Test Results: When cellular abnormalities are detected.
- Cervical Dysplasia: Presence of precancerous changes in cells.
- HPV Infection: Cellular changes caused by high-risk HPV types.
- Cancer Suspicion: In patients at risk of cervical cancer.
Conization plays an important role in the early diagnosis and treatment of cervical cancer.
How is Conization Performed?
Conization is a procedure usually performed under local anesthesia in an outpatient clinic setting. The procedure takes an average of 10-20 minutes and the patient can be discharged the same day. The LEEP technique is a widely used and relatively simple method.
Steps of Conization with the LEEP Technique:
- Anaesthesia Application: During the procedure, local anesthesia is applied to the patient's cervix. This prevents pain during the procedure.
- Speculum Placement: A tool called a speculum is used to open the vagina.
- Tissue Removal: Using a thin wire loop, abnormal cells in the cervix are cut and removed with the help of an electric current.
- Bleeding Control: After the procedure, pressure is applied to the area using some chemical solutions or electric current to stop bleeding.
The removed tissue sample is sent to the laboratory and examined under a microscope.
Preparation Before Conization
Some preparations should be made before, during and after the conization procedure to minimize the risk of any complications.
Things to Consider Before the Procedure:
- Should Be Performed Outside of the Menstrual Period: Conization should be performed outside of the menstrual period. Procedures performed during menstruation may cause more bleeding.
- Avoiding Intercourse: It is recommended not to have sexual intercourse 24-48 hours before the procedure.
- Avoiding Vaginal Product Use: Vaginal douche, tampons or other vaginal products should not be used.
- Using Painkillers: Taking a mild painkiller before the procedure may reduce discomfort, but you should do this after consulting your doctor.
These preparations make the procedure more comfortable and reduce the risk of complications.
Post-Conization Recovery Process
The recovery period after the conization procedure usually lasts a few weeks. Light bleeding and vaginal discharge are common after the procedure. Full recovery time can range from approximately 4-6 weeks.
Things to Consider During Recovery:
- Bleeding and Discharge: Light bleeding or spotting may occur for a few weeks after the procedure.
- Avoid Heavy Lifting: Heavy lifting should be avoided during the healing process.
- Using Tampons: Tampons should not be used until the healing process is complete after the procedure.
- Avoiding Sexual Intercourse: It is recommended not to have sexual intercourse until the healing process is complete (usually 4-6 weeks).
Your doctor will give you special instructions during the healing process and explain how to act in case of any complications.
Sexual Life After Conization
It is important not to have sexual intercourse until the healing process in the cervix is complete after the conization procedure. This period usually varies between 4-6 weeks. After healing is complete, your doctor will tell you when you can resume sexual intercourse.
Having intercourse early can increase the risk of infection and negatively affect the healing process.
Is Conization a Painful Procedure?
Conization is usually painless because it is a procedure performed under local anesthesia. Only slight pressure may be felt during the procedure. However, mild cramping or discomfort may be felt after the procedure. This discomfort can be controlled with simple painkillers and usually goes away within a few days.
If you feel severe pain during or after the procedure, you should definitely report it to your doctor.
Side Effects of Conization
Conization is generally a safe procedure. However, as with any surgical procedure, some side effects may occur.
Possible Side Effects:
- Light Bleeding: Light bleeding or spotting is common for a few days after the procedure.
- Vaginal Discharge: A whitish or slightly bloody vaginal discharge may occur for a few weeks after the procedure.
- Cramps: Mild cramping is common after the procedure.
- Infection: In rare cases, an infection may develop. Fever, intense pain, or foul-smelling discharge may be signs of infection.
These side effects usually pass in a short time, but if you notice any unusual symptoms, you should contact your doctor.
Conization and Pregnancy
Conization is a procedure that generally does not affect fertility. However, in some cases, the risk of miscarriage or premature birth may increase due to structural changes in the cervix. Therefore, women planning a pregnancy after conization should discuss this with their doctors.
Before planning a pregnancy, it should be ensured that full recovery is achieved. Your doctor will inform you about the things to consider during pregnancy after conization.
Conization Results
The tissue sample taken after the conization procedure is examined in the laboratory to evaluate the presence and degree of abnormal cells. The results determine whether the procedure was successful and whether further treatment is needed.
Conization Results:
- Normal Result: If the abnormal cells have been completely removed and there is no risk of cancer, regular follow-up is usually continued.
- Abnormal Result: If precancerous cellular changes are detected, additional treatment methods may be required.
Your doctor will create an appropriate treatment or follow-up plan for you based on the results.
Post-Conization Follow-up
It is important to have regular check-ups after conization. Smear tests and HPV tests are used to monitor whether the cellular changes in the cervix have developed again. Usually, a check-up is done within the first 6 months and then followed up at regular intervals.
If the abnormal cells have been completely removed, no additional treatment is usually required. However, additional treatments may be required in case of recurring abnormalities.
Frequently Asked Questions (FAQ)
1. Is conization painful?
Conization is performed under local anesthesia, so there is no pain during the procedure. However, there may be slight discomfort after the procedure.
2. When can I resume sexual intercourse after conization?
Sexual intercourse can usually be resumed after 4-6 weeks. However, the healing process may vary from person to person, so you should consult your doctor.
3. Does conization affect fertility?
Conization generally does not affect fertility. However, in rare cases, the risk of miscarriage or premature birth may increase due to changes in the cervix.
4. How long does it take to recover after conization?
The full recovery period is usually 4-6 weeks. It is recommended to avoid strenuous activities and sexual intercourse during this time.
5. How long does bleeding last after conization?
Light bleeding or spotting can usually last from a few days to a few weeks.
6. Can conization be used in cancer treatment?
Conization is used to treat precancerous cellular changes. If cancerous cells are detected, additional treatment methods may be applied.
