Cone Biopsy

A cone biopsy is a quick outpatient surgery used to find and treat a problem in the cervix. Your health care provider may do a cone biopsy if one or more Pap tests and a colposcopy (microscope) exam showed abnormal cells on your cervix. A cone biopsy takes less than an hour. You’ll be able to go home the same day. The most common type of cone biopsy is the loop electrosurgical excision procedure (LEEP). A wire with electric current is used to take the biopsy.

Preparing for a cone biopsy

The procedure is most often done when you are not having your menstrual period. This will give your health care provider a clear view of your cervix. Follow any directions you are given for not eating or drinking before surgery. You’ll also need to have an adult friend or family member drive you home afterward. Be sure to arrive at the hospital, surgery center, or provider's office in time to sign in and get ready. Your provider might give you a single dose of antibiotics before the procedure to prevent infection.

Your surgery

Here is what to expect during surgery:

• You’ll be given anesthesia before your biopsy to keep you comfortable during surgery.

• Your health care provider then puts a thin metal tool (speculum) into your vagina to see your cervix.

• Then a cone-shaped piece of tissue is removed from the cervix. The tissue is cut from the opening up into the canal. This may be done with a small knife or with a laser or with the LEEP wire. You may feel pressure, a dull ache, or cramping during this step.

• A special cream may be put on your cervix to control bleeding. 

• The tissue that is removed is then sent to the lab. The lab studies the tissue and makes sure the abnormal cells have been cut away. New tissue grows back in the cervix in 4 to 6 weeks.

Recovery from a cone biopsy

After the procedure, you may have:

• A pink, liquid discharge.

• Mild cramps.

• A dark-colored discharge (from the cream used).

Don’t use tampons, don’t douche, and don’t have sex until your health care provider says it's okay. Don't swim or take tub baths for a few weeks, until your cervix heals completely. Showers are fine.

Your provider will schedule a follow-up exam a few weeks after treatment to make sure your cervix is healing properly.

When to contact your doctor

Contact your health care provider if you have:

• Heavy bleeding, bleeding that’s heavier than the heaviest day of your period, or bleeding with clots.

• Fever over 100.4°F (38°C) or higher, or as directed by your provider.

• Chills.

• Bad-smelling vaginal discharge.

Possible risks of a cone biopsy

Your health care provider will discuss with you the risks and possible problems of a cone biopsy. These include:

• Not removing all of the abnormal tissue.

• Severe bleeding.

• Infection.

• Weakening or scarring of the cervix that could lead to preterm birth.

• Narrowing of the cervix (cervical stenosis), which may cause more pain, cramps, or bleeding during your periods.