Introduction/Background Many childbearing women are at risk of cervical cancer worldwide. Adenocarcinoma in situ (AIS), the only known precursor of invasive adenocarcinoma of the cervix, is increasing in incidence, particularly in women of reproductive age. For younger patients who are seeking fertility perseveration, negative margins correlate with a better chance of success with conservative management. Popular conservative treatment options include LEEP and cold knife conization(CKC).

Methodology A 38 years old woman with the suspicious of adenocarcinoma in situ underwent cervical cold knife conization. Because of a wide cervical os, a 16 Fr Foley catheter was inserted through the os and the baloon of the catheter was inflated with sterile water. After being sure the baloon of the catheter was filled enough, 360 degrees directional movement of the uterine cervix was feasible and inserting the scalpel into the relatively soft cervical tissue in one move was possible.

Results To manipulate a larger volume cervix, a Foley catheter was inserted through the cervical canal. Manipulation of the cervix provided a faster procedure with less bleeding and excellent bleeding control. An intact cone shaped specimen with pathological confirmed negative margines was obtained.

Conclusion Achieving negative margins, diagnosis of invasive cancer if present, and preventing recurrence is the mainstay of concervative treatment of AIS. For woman with large volume uterine cervix, it is difficult to perform an intact cone shaped material. After conization, it is also difficult to see and control bleeding of the remaining inverted cervical tissue. Foley catheter is a cheap and easily accessible method for high volume uterine cervix manipulation during and after cold knife conization.

Disclosures None