A cone biopsy is a surgical procedure where a cone shaped piece of tissue is excised or removed from the cervix for examination.

Why do I need a cone biopsy?

When you have a colposcopy, sometimes not all the abnormal cells can be seen as some of the abnormal cells may be higher up the neck of the womb, or the cervical canal. There is the possibility that these abnormal cells higher up may not be completely excised using the more common, LLETZ procedure.

There may be other indications why you may need a cone biopsy and your doctor will discuss this with you.

How is a cone biopsy done?

This is a surgical procedure done in the operating theatre usually under general anaesthetic.

  • Once you are asleep, you will be placed on the operation table, your legs placed in stirrups and then an antibiotic administered intravenously.
  • A speculum is inserted into the vagina and the cervix visualised.
  • Local anaesthetic mixed with adrenaline is injected around the cervix. This helps to prevent post-operative pain and helps control bleeding during the procedure. Stitches may also be placed around the cervix to help control bleeding
  • A circular shaped incision is made round the cervix. The incision is advanced deeper into the cervix to include a depth of about 2cm to obtain an 'ice-cream cone' shaped excised tissue. The aim is to remove abnormal tissues in the deeper parts of the cervix that may not have been adequately seen at the colposcopy examination.
  • A curette is done of the cervical canal – a scratch biopsy of the canal of the neck of the womb to ensure these cells are normal when examined under the microscope.

Specific risk to pregnancy / future pregnancies

  • Please tell us if you could be pregnant before you have a cone biopsy.
  • A cone biopsy increases your risk of a premature birth by 2-3 times. It is important to let your health practitioner know if you do fall pregnant in the future. You will need an ultrasound early in your pregnancy to measure the remaining length of the cervix. Most women will be able to carry their pregnancy to full term, but a small proportion of women may need a procedure called a cervical suture to reduce their risk of premature delivery..

Recovery and follow up is similar to having a LLETZ procedure.