Short- and long-term complications and the impact on quality of life after cervical conization by harmonic scalpel Megumi Furugori 1 , Mikiko Asai-Sato 1 , Kayoko Katayama 2 , Fumiki Hirahara 1 and Etsuko Miyagi 1 1 Department of Obstetrics and Gynecology and Molecular Reproductive Science, Yokohama City University, and 2 Cancer Prevention and Cancer Control Division, Kanagawa Cancer Research Institute, Yokohama, Japan Abstract Aim: 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 under- gone harmonic conization participated in a questionnaire survey regarding perisurgical complications and post- surgical 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 postoper- ative 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%) indi- cated 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. Conclusion: 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. Key words: cervical cancer prevention, cervical conization, cervical intraepithelial neoplasia, harmonic scalpel, quality of life. Introduction The development of national cancer prevention pro- grams has undeniably contributed to the early detection of cervical cancer worldwide. Particularly in Japan, the incidence of high-grade intraepithelial squamous lesions (HSIL) and micro-invasive carcinoma (MIC) in young women is gradually increasing, 1,2 which has resulted in a greater number of women who have undergone conization of the uterine cervix. Cervical conization is a minimally invasive surgical procedure that is widely used in many countries. However, some complications have been associated with cervical conization that require proper management. Particularly, the increased Received: August 29 2016. Accepted: November 25 2016. Correspondence: Associate Professor Mikiko Asai-Sato, Department of Obstetrics and Gynecology and Molecular Reproductive Science, Yokohama City University, Fukuura 3-9 Kanazawa-ku, Yokohama 236-0004, Japan. Email: mikikos@yokohama-cu.ac.jp © 2017 Japan Society of Obstetrics and Gynecology 1 doi:10.1111/jog.13273 J. Obstet. Gynaecol. Res. 2017