Cone biopsy

You may be offered a cone biopsy if:

• High-grade abnormalities are found on your smear test
• The abnormal cells extend into the cervical canal and cannot be completely removed with a LLETZ procedure
• Your previous treatment has not fully removed abnormal cells
• There is uncertainty in the diagnosis and a larger tissue sample is needed

The procedure is usually done under general anaesthetic in a private hospital, although sometimes local anaesthetic is used. A cone-shaped piece of tissue is carefully removed from the cervix using a scalpel or laser. The removed tissue is sent to the lab for detailed examination. 

Yes. While both remove abnormal cells from the cervix, a cone biopsy takes a larger and deeper sample of tissue, often from higher inside the cervical canal. It is usually reserved for more complex or persistent cases.

• You may experience some vaginal bleeding or discharge for up to 2–4 weeks
• It’s recommended to avoid sex, swimming, and using tampons for 4 weeks to allow healing
• Most women can return to work and normal activities within a few days
• You’ll be offered a follow-up appointment to discuss results and next steps

Most women go on to have healthy pregnancies after a cone biopsy. However, there may be a slightly increased risk of preterm birth or cervical weakness, especially if a large amount of tissue is removed, this will be discussed during your consultation.

As with any surgical procedure, there are small risks. These include:

• Bleeding
• Infection
• Cervical stenosis (narrowing of the cervix)
• Cervical insufficiency in future pregnancies (in rare cases)

Results from the biopsy are usually available within 2–3 weeks. Your consultant will contact you to discuss the findings and whether any further treatment or monitoring is needed.