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Hello, I am 47 years old and the doctors have bad news for me. There is some change on my cervix but they are still not sure what it is. Therefore, cervical conization has to be done, but I am not sure how is that procedure performed. Is it something painful? Is an anesthesia given, local or total?

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I know of this procedure only what my friend told me and as I recall it, she said that she was under a total anesthesia. And with an instrument called speculum a sample of the cervical tissue is taken, of course from the area that is showing the signs of the change. The wound that remained might be left open and frozen or heated to stop the bleeding. The patient is usually released the next day.
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A cervical conization can be done using a cold knife, a laser, or a loop. Your doctor will decide which would be best for you depending on how much tissue needs to be removed and on how thick the portion needing removal may be. The procedure is usually done in outpatient surgery and you can go home later that day. It is usually done under general anesthesia and should take 15-30 minutes. If the amount of tissue being removed is small or if the patient is pregnant, they may opt for local or regional anesthetic as opposed to general anesthesia. Local can be done by injecting anesthetic into the cervix itself or regional can be done via epidural or spinal anesthesia. You'll lie on the table and your feet will be put in stirrups as if you were having a regular Pap test. The doctor will use a colposcope which is an instrument used to magnify the cervix and help the doctor see better. He or she will then remove the tissue in question from the cervix and might stitch a flap of tissue over the hole that is made. You will have some cramping and some bleeding following the procedure. You shouldn't do any heavy lifting and should relax for the rest of the day. You should watch for any increase in bleeding at home and contact your doctor if you develop a fever, increased bleeding, or extremely painful cramping. You should avoid douching, tampons, and sex for about 4 weeks after the procedure is preformed. Follow up with a pelvic exam and Pap smear is very important to make sure you do not have any further cervical dysplasia.
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