title: Short- and long-term complications and the impact on quality of life after cervical conization by harmonic scalpel.
abstract: OBJECTIVE
  The incidence of non-obstetrical complications after cervical conization is low, and women receive minimal postsurgical attention. In this study, we investigated whether women felt any discomfort after undergoing conization by harmonic scalpel, one of the hot-knife devices widely used in Japan.
  
  
  METHODS
  Eighty-eight women aged 20-47 years who were still experiencing menstrual cycles and had undergone harmonic conization participated in a questionnaire survey regarding perisurgical complications and postsurgical changes in gynecological issues. Correlations between the occurrence of postoperative complications and clinical characteristics were analyzed.
  
  
  RESULTS
  Regarding the complications immediately after the surgery, 37 women (45.1%) complained of postoperative bleeding that was heavier than their usual menstrual bleeding, and 14 (18.2%) reported that the postsurgical bleeding was greater than they had expected. Regarding long-term gynecological changes after conization, 27 women (30.7%) reported that the duration of menstrual bleeding had increased after the surgery, 20 (22.7%) indicated that pain during menstruation had changed, and 40 (45.5%) stated that the amount of menstrual bleeding had changed. Irregular genital bleeding outside of menstruation appeared in 23 women (26.4%). Additionally, 24 (27.6%) of the women reported that the conization procedure negatively impacted their quality of life. Finally, the occurrence of long-term atypical bleeding after the surgery was significantly correlated with the thickness and circumference of the tissue specimen.
  
  
  CONCLUSIONS
  Several women experienced a significant change in quality of life after harmonic conization. Women who undergo conization should receive a comprehensive preoperative overview of the procedure and attentive postsurgical care.
authors.affiliation: Department of Obstetrics and Gynecology and Molecular Reproductive Science, Yokohama City University, Yokohama, Japan.
authors.forename: Megumi
authors.initials: M
authors.lastname: Furugori
authors.affiliation: Department of Obstetrics and Gynecology and Molecular Reproductive Science, Yokohama City University, Yokohama, Japan.
authors.forename: Mikiko
authors.initials: M
authors.lastname: Asai-Sato
authors.affiliation: Cancer Prevention and Cancer Control Division, Kanagawa Cancer Research Institute, Yokohama, Japan.
authors.forename: Kayoko
authors.initials: K
authors.lastname: Katayama
authors.affiliation: Department of Obstetrics and Gynecology and Molecular Reproductive Science, Yokohama City University, Yokohama, Japan.
authors.forename: Fumiki
authors.initials: F
authors.lastname: Hirahara
authors.affiliation: Department of Obstetrics and Gynecology and Molecular Reproductive Science, Yokohama City University, Yokohama, Japan.
authors.forename: Etsuko
authors.initials: E
authors.lastname: Miyagi
mesh_terms: D000328:Adult; D019092:Conization / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006801:Humans; D008875:Middle Aged; D011183:Postoperative Complications / Q000503:physiopathology*; D011788:Quality of Life; D059708:Ultrasonic Surgical Procedures / Q000009:adverse effects* / Q000379:methods; D002578:Uterine Cervical Dysplasia / Q000601:surgery*; D055815:Young Adult
keywords: cervical cancer prevention; cervical conization; cervical intraepithelial neoplasia; harmonic scalpel; quality of life