COLPOSCOPY

What is colposcopy?

A colposcopy is a procedure to find out whether there are abnormal cells on or in a woman’s cervix or vagina. The cervix is the part of the womb that sits in the vaginal.

Abnormalities tend to occur at the opening of the cervix to the birth canal, where it enters the womb. A colposcopy allows a doctor or trained nurse to find these abnormalities.

In some women, the presence of “abnormal cells” carries the risk of developing cervical cancer. A colposcopy is used to determine whether treatment will be needed to deal with these cells.

What is the procedure for colposcopy?

For at least 24 hours before your appointment avoid having sex or using vaginal medications, lubricants, creams or tampons.

Bring a panty liner – as you may have some light bleeding or discharge afterwards.

You can eat and drink as normal.

 

Contact the clinic before your appointment if:

  • you think your period might arrive around the time of your appointment – you’ll usually still be able to have the procedure, but in some cases you may be advised to postpone it
  • you’re pregnant – a colposcopy is safe during pregnancy, but a biopsy (removing a tissue sample) and any treatment will usually be delayed until a few months after giving birth
  • you want the procedure to be done by a female doctor
  • You can bring a friend, partner or family member with you to United Medical clinic if you think it will help you feel more at ease
When a colposcopy is needed?

You may need a colposcopy after having a routine cervical screening test. Other reasons for having a colposcopy may include:

  • some of the cells in your cervical screening sample are abnormal (but not necessarily cancerous)
  • you are infected with human papillomavirus (HPV), which is the main cause of the abnormal cell changes and might lead to cancer
  • you’ve had several screening tests, but it wasn’t possible to give you a result
  • the nurse or doctor who carried out your screening test thought your cervix didn’t look as healthy as it should

A colposcopy can also be used to investigate things such as unexplained vaginal bleeding (for example, after sex) or an inflamed cervix.

What happens during a colposcopy?

The procedure is usually carried out in United Medical clinic by a specialist called a colposcopist. This is done via a specialist doctor.

You’ll be asked to lie down in a special type of chair with padded supports to rest your legs on. A device called a speculum will be inserted into your vagina and gently opened to allow the colposcopist to examine your cervix.

A microscope (colposcope) with a strong light will be used to look at your cervix. The colposcope doesn’t enter the vagina and remains outside your body. If the colposcope has a camera attached to it, you may be able to see images of your cervix on a small screen. Some solutions will be applied to the cervix to highlight the abnormal areas.

If any abnormal areas are identified, a small sample of tissue (a biopsy) may be removed for closer examination. A biopsy is similar to a small pinch or scratch in terms of sensation and shouldn’t be too painful. The purpose of a biopsy is to confirm whether your screening test has been correct in identifying a problem.

However, the colposcopist will sometimes be confident that the screening test has been correct without the need for a biopsy and may decide to proceed immediately to treatment (see below).

What to take note after a colposcopy?

After having a colposcopy:

  • you’ll be able to go home as soon as you feel ready, usually straight afterwards
  • you can return to your normal activities, including work and driving, immediately – although some women prefer to rest until the next day
  • you may have a brownish vaginal discharge, or light bleeding if you had a biopsy – this is normal and should stop after three to five days
  • wait until any bleeding stops before having sex or using tampons, vaginal medications, lubricants or creams
What are the types of abnormal result?

About 6 in every 10 women have abnormal cells in their cervix – known as cervical intra-epithelial neoplasia (CIN) or cervical glandular intra-epithelial neoplasia (CGIN).

This isn’t cancer, but there’s a risk it could turn into cancer if untreated.

Abnormal cells may be detected while a colposcopy is carried out, but a biopsy will be needed to determine what the risk of these becoming cancerous is and whether treatment is needed.

The different types of abnormal biopsy result and what they mean are as follows:

  • CIN 1 – it’s unlikely the cells will become cancerous and they may go away on their own; no treatment is needed and you’ll be invited for a cervical screening test in 12 months to check they’ve gone
  • CIN 2 – there’s a moderate chance the cells will become cancerous and treatment to remove them is usually recommended
  • CIN 3 – there’s a high chance the cells will become cancerous and treatment to remove them is recommended
  • CGIN – there’s a high chance the cells will become cancerous and treatment to remove them is recommended
When treatment is carried out

LLETZ

The most common treatment is large loop excision of the transformation zone (LLETZ). It:

involves removing the abnormal cells using a thin wire loop that’s heated with an electric current can be carried out at the same time as a colposcopy is usually done while you’re awake – local anaesthetic is injected into your cervix to numb it during the treatment doesn’t usually need an overnight stay in hospital.

LLETZ is also called loop diathermy, loop cone, loop biopsy or loop excision.

 

Cone biopsy

A cone biopsy is done less often than LLETZ. It:

  • is a minor operation to cut out a cone-shaped piece of tissue containing the abnormal cells
  • only tends to be used if a large area of tissue needs to be removed

 

Other treatments

Abnormal cells in the cervix can also be treated with:

  • cryotherapy – the abnormal cells are frozen and destroyed (this is only used to treat minor cell changes)
  • laser treatment – a laser is used to pinpoint and destroy abnormal cells on your cervix
  • cold coagulation – a heat source is applied to the cervix to burn away the abnormal cells
  • hysterectomy (removal of the womb) – this will only be considered if abnormal cells on your cervix have been found more than once, if they’re severely abnormal, you’re past childbearing age, or you don’t want to have more children
Planning Ahead
You may wish to prepare a list of questions to ask before seeing us so that you will not miss out anything important. Ask for the appointment on a day when you know you will not be having your period. Be sure to bring a list of all medications and supplements that you are taking.
Can I walk in for an appointment or service?
We want to make sure we cater enough time for your visit with our doctor. As such, we strongly advise that you make a prior appointment with our staff. Our specialist will then meet you on the allocated time for a detailed discussion. Please call or email us for an appointment.
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