[Conization of the uterine cervix in prevention and diagnosis of cancer (author's transl)].

The result of conization of the uterine cervix in 446 cases was reviewd regarding the diagnostic and preventive therapeutic value of the procedure with special attention to post-operative complications. Conizations for benign lesions of the cervix in 33 patients resulted in a well formed cervix with squamous epithelium covering of the ectocervix in 32 patients. There was only 1 failure. In 413 diagnostic conizations with extensive microscopic work-up the lesion was only completely removed in 62% of the cases. In spite of careful colposcopy and Schiller iodine marking the external margin of the cone biopsy material went through the atypical lesion in 51% of the cases. It is therefore necessary to extend the limits of the cone biopsy specimen in all cases as far to the periphery and upwards into the canal as feasible. The incidence of early and late complications was 10.9%. In 133 conizations with hemostasis by cauterization the complication rate was 22.6%. This rate was reduced to a complication rate of 5.2% in 261 cases with hemostasis by suture. The commonest early complication was cervical bleeding. The only late complication was stenosis of the cervical canal. After conization of the cervix 18 of 22 pregnancies were uncomplicated. The increased incidence of cervical dystocia following conization of the cervix is significant and was the indication for Caesarean Section in 6 cases. For the prevention of cancer, the indication for conization of the cervix should be diminished in favor of an increase of the indication for hysterectomy because of the high failure rate of conization to prevent cancer (37%) and because of the relatively high incidence of complications of conization.