What should you know about cold knife cone biopsy?

It is also called cold knife conisation. The sample includes tissue from the surface of the cervix and the cervical canal, allowing a pathologist to examine the cells and the specimen edges.

A gynaecologist may recommend the procedure after cervical screening, colposcopy or a smaller biopsy identifies abnormal cells, or when the affected area extends into the cervical canal. A scalpel is used rather than a heated wire loop, which can help preserve tissue edges for examination. The laboratory report describes the cell changes, whether abnormal tissue reaches a cut edge, and whether further assessment or treatment may be needed. A cone biopsy result does not by itself determine every next step.

Follow the hospital's instructions about eating, drinking and medicines because an anaesthetic is commonly used. Mention blood-thinning medicines, pregnancy or possible pregnancy, allergies and previous reactions to anaesthesia. Arrange transport home if advised. During recovery, use pads rather than tampons, and avoid vaginal sex, swimming and strenuous activity until the clinical team says healing is adequate. Light bleeding, cramping and watery or dark discharge can occur; follow the discharge instructions for pain relief and wound care.

Contact the treating team promptly for bleeding that soaks through pads, passing large clots, worsening pelvic pain, fever, foul-smelling discharge, difficulty passing urine, dizziness or fainting. Seek emergency help for severe bleeding, collapse, chest pain or breathing difficulty. These symptoms guide urgency; do not wait for the pathology appointment if they occur.

Ask what prompted the cone biopsy, which anaesthetic is planned, and how your regular medicines should be handled. Afterward, ask what the pathology says about the type and extent of cell changes and the specimen edges. Clarify the follow-up plan and whether the procedure could affect future cervical monitoring or pregnancy care.