Having a colposcopy can be a traumatising experience, if you don’t know what to expect. Hundreds of thousands of women in the UK are diagnosed with abnormal cells in their cervix, but this should be seen as a positive thing as more and more women adhere to cervical cancer prevention programmes. Miss Amanda Ali, Consultant Gynaecologist and Colposcopist at New Victoria Hospital talks to you about the importance of colposcopy and what to expect at your appointment.
Having abnormal cervical cells is not uncommon. About 1 in 20 smear test results come back abnormal. And this is where a simple colposcopy procedure can play a major role in giving you peace of mind.
According to the latest Jo’s Trust Survey about 50% of women have no prior knowledge of cervical cell changes before their diagnosis.
More information can certainly help to make more women feel at ease when it comes to cervical cancer screening and undergoing a colposcopy procedure.
What is a Colposcopy?
A colposcopy is an examination that takes a closer look at your cervix. This is done using a colposcope which is a microscope that magnifies the cervix up to 40 times its normal size.
The examination takes about 10-20 minutes. The doctor, who is usually a Gynaecologist specialised in this type of examination, will be accompanied by a nurse who will be present for the duration of your consultation.
Who needs a Colposcopy?
You might need a Colposcopy if you have:-
- Abnormal smear
- Abnormal appearance of the cervix
- Abnormal bleeding/discharge
What should you expect during a Colposcopy?
When you come into the colposcopy room, you will be given a private space to undress from the waist down and you will be given a hospital gown to wear. You will then be asked to lie down on a special examination couch and to place your legs on footrests or stirrups.
The first part of a colposcopy is very similar to having a cervical smear test. Your doctor will gently insert a new plastic speculum into your vagina using some lubricant. The colposcope itself does not go inside the body.
Your cervix will be examined by looking through the colposcope.
One or two liquids will be applied to your cervix using a cotton ball. These liquids highlight any abnormal areas on your cervix by changing colour. You will not feel pain but you may feel some wetness when the liquids are applied.
Cervix cells might be collected and analysed
If necessary, a sample may need to be taken from any abnormal areas within your cervix. This sample is called a biopsy which involves removing a very small amount of tissue that will then be sent to a laboratory for testing.
If a biopsy is needed you will be offered a local anaesthetic which will be injected into your cervix with a very thin needle, similar to a dental needle used for tooth extraction.
It is not always necessary to have a local anaesthetic for a biopsy, and most women only feel a small pinch when the biopsy is taken.
Following a biopsy you may feel period-like cramps and have some light spotting or brown discharge. This usually settles within a day or two.
You will be advised to refrain from intercourse, using tampons, and swimming for 3-4 days until the area has healed and your bleeding or discharge have settled. If your bleeding or pain persists for more than one week, you should contact your doctor or GP.
Your doctor will reassure you after the colposcopy examination is complete, however if a biopsy was taken, they will write to you with the results once they are available.
Treatment of abnormal cells
If you need treatment, it may be offered during your first colposcopy appointment or you may be invited back to have treatment at another appointment.
The option you are offered will be based on what the colposcopy examination shows, your preference and your doctor’s practice.
If you are offered treatment during your first appointment, you can ask for time to think about it before you go ahead. This is known as "See and treat".
Your doctor will invite you to have a seat away from the examination bed to talk you through the treatment, and ensure that you understand the procedure, including any possible risks or side effects.
If you are going to have treatment at a later date, you will be given an information leaflet detailing the procedure and after care.
What treatment is available?
Large Loop Excision of Transformation Zone (LLETZ)
LLETZ is the most common treatment to remove abnormal or precancerous cells from the cervix. This procedure uses a thin wire loop with an electrical current to remove the affected area of the cervix.
You can have a LLETZ under local anaestheteic in the colposcopy room or you can choose to have it under general anaesthetic in an operating theatre as a day case.
Whichever option you choose, your doctor will explain the procedure in detail to you and give you a chance to ask questions. Following a LLETZ procedure the cervix will take between 4-6 weeks to heal. You will be advised again to refrain from sexual intercourse, using tampons and swimming for 4 weeks until the cervix has healed.
You will also be given written information on what to expect afterwards and advice on aftercare.
Your doctor will write to you with your results once they are available. You will usually require a smear test approximately 6 months following a LLETZ procedure; this smear is called a "test of cure" smear and it ensures that all the abnormal area has been removed and your smears have returned to normal.
What are the benefits of having a Colposcopy?
Although there are some risks with treatment including infection and a slightly increased risk of premature birth, the benefits are greater, as with treatment the abnormal area will be removed and your smears will return to normal.
Only 1 in 2000 women will have cervical cancer, which is 0.05%. A colposcopy will allow you to have a prompt diagnosis and treatment.
If you would like further information on Colposcopy at New Victoria Hospital or if you are at all concerned, you can speak to one of our specialist Consultant Gynaecologists. Call us on 020 8949 9020 or fill in our online form