Tokuda

Conization of the cervix is an excision of a cone-shaped or cylindrical wedge from the cervix uteri that includes the transformation zone and all or a portion of the endocervical canal.

It is used for the definitive diagnosis of squamous or glandular intraepithelial lesions, for excluding microinvasive carcinomas, and for conservative treatment of cervical intraepithelial neoplasia (CIN).

Diagnostic conization

Diagnostic conization is indicated in the following situations:

• Finding epithelial cell abnormalities, in particular high-grade squamous intraepithelial lesions (HSIL) or low-grade squamous intraepithelial lesions (LSIL) in the absence of gross or colposcopic lesions of the cervix
• Unsatisfactory colposcopy, defined as the examiner's inability to view the entire transformation zone, including the squamocolumnar junction, in women with epithelial cell abnormalities
• Uncertainty regarding the presence or absence of microinvasion or invasion following the diagnosis of CIN by directed biopsy
• Finding CIN or microinvasive cancer during endocervical curettage
• Cytologic or histologic evidence of premalignant or malignant glandular epithelium
• Cytologic diagnosis inconsistent with histologic diagnosis based on directed biopsy findings