CHAPTER 4: SCREENING FOR CERVICAL CANCER

PS 14: Cold Knife Conization 163At the first follow-up visit (2–6 weeks)13. A speculum examination will be done to determine if the wound has fully healed.14. The laboratory results will be discussed and the next steps planned.15. The patient will be advised to return in 6 months and 12 months for assessment.At 6 months and 12 months16. A Pap test and colposcopy will be done, and a biopsy if necessary. The patient willthen be followed up as described in Annex 5.Annex 5FOLLOW-UP AT HOMEBefore she leaves hospital, the woman will be given counselling on how to take care ofherself, and what symptoms of complications to look for. You can help her by reinforcingthis advice.1. If gauze packing was left in the vagina, it must be removed within 6-12 hours toavoid infection. If there is a local health care provider who knows how to do this,he or she can assist the woman.2. Relative rest for a few days is recommended. The patient should avoid heavy workfor the first three weeks. Normal daily activities can be performed, such as lighthousework, bathing, showering, and eating.3. If the patient has discomfort (not severe pain), she may take paracetamol.Flowchart precancer4. She will have a hidden wound in the vagina, which needs at least 4–6 weeks toheal. To prevent infection and allow proper healing, she should not put anythinginto the vagina for that time, including fingers or tampons, and she should notdouche or have sexual intercourse (although she can be intimate in other ways). Ifshe is unable to abstain from intercourse, provide condoms and teach her (and herpartner) how to use them.5. Make sure she knows the symptoms of complications (see next page) and instructher to go to the health centre or hospital immediately if any of them occur.6. She should have been given an appointment for a check-up in 2–6 weeks todiscuss the results of the tissue examination and to be examined by the surgeon.Encourage her to keep this appointment.PS 14Practice Sheet 14: Cold Knife Conization