Atlas of Colposcopy: Principles and Practice / Activity 5

The side-effects and complications of cold-knife conization are similar to those of LLETZ, although the frequency and intensity of these tend to be much higher with cold-knife conization.

The side-effects and complications are:

• Primary haemorrhage during or immediately after surgery
• Secondary haemorrhage due to postoperative infection
• Postoperative infection characterized by foul-smelling vaginal discharge, bleeding, and lower abdominal pain with or without fever
• Cervical stenosis
• Cervical incompetence, leading to second-trimester miscarriages in subsequent pregnancies
• Premature rupture of membranes and preterm labour in subsequent pregnancies.

The post-treatment advice and follow-up protocols for cold-knife conization are the same as those for LLETZ.