Colposcopy

A colposcopy is a simple procedure used to look at the cervix, the lower part of the womb at the top of the vagina. You usually get a colposcopy if you had some sort of abnormal results on your Pap test so your doctor can further diagnose any problems.

These cells often go away on their own, but sometimes there's a risk they could eventually turn into cervical cancer if not treated.

A colposcopy can confirm whether cells in your cervix are abnormal and determine whether you need treatment to remove them.

A colposcopy is usually carried out in a hospital clinic. It takes around 15 to 20 minutes and you can go home soon afterward.

WHEN COLPOSCOPY IS NEEDED?

You may be referred for a colposcopy within a few weeks of cervical screening if:-

(A) Some of the cells in your screening sample are abnormal,

(B) The nurse or doctor who performed the screening thought your cervix did not look as healthy as it should, or

(C) It was not possible to give you a clear result after several screening tests, you may be referred for a colposcopy within a few weeks of cervical screening.

A colposcopy can also be used to find out the cause of problems such as unusual vaginal bleeding (for example, bleeding after sex).

Try not to worry if you've been referred for a colposcopy. It's very unlikely you have cancer and any abnormal cells will not get worse while you're waiting for your appointment.

PREPARING FOR A COLPOSCOPY

• For at least 24 hours before your appointment avoid having sex or using vaginal medicines, lubricants, creams, tampons, or menstrual cups
• Bring a panty liner, as you may have some light bleeding or discharge afterward
• You can eat and drink as normal

Contact the clinic before your appointment if:-

(A) You think your period will arrive around the time of your appointment you'll usually be able to have the procedure, but you may be advised to postpone it.

(B) You're pregnant a colposcopy is safe during pregnancy, but a biopsy (removing a tissue sample) and any treatment will usually be delayed until after the baby is born.

(C) You want the procedure to be done you'll usually be able to have the procedure, but you may be advised to post.

If you think it will make you feel more at ease, you can bring a friend, partner, or family member with you to the hospital.

PROCEDURE

A colposcopy is carried out by a specialist called a colposcopist. This may be a doctor or a trained nurse.

During the procedure:

• You undress from the waist down (a loose skirt may not need to be removed) and lie down in a chair with padded supports for your legs
• A device called a speculum is inserted into your vagina and gently opened similar to having a cervical screening test.
• A microscope with a light (a colposcope) is used to look at your cervix this stays outside your vagina
• Liquids are applied to your cervix to highlight any abnormal areas you may feel a mild tingling or burning sensation when these are applied
• A small sample of tissue (a biopsy) may be removed for closer examination in a laboratory this should not be painful, but you may feel a slight pinch or stinging sensation

If it's obvious that you have abnormal cells in your cervix, you may be offered treatment to remove the cells immediately. Otherwise, you'll need to wait until you get your biopsy result.

AFTER COLPOSCOPY

After having a colposcopy:-

(A) You'll be able to return home as soon as you're ready, which is usually right away.

(B) You can immediately resume your normal activities, such as driving and working, however, you may choose to rest until the next day.

(C) If you had a biopsy, you may have a brownish vaginal discharge or light bleeding; this is normal and should go away in 3 to 5 days.

(D) Before having sex or using tampons, menstrual cups, vaginal medicines, lubricants, or lotions, wait until any bleeding has stopped.

Your nurse or doctor may be able to tell you what they've found straight away.

If you have had a biopsy, it will be checked in a laboratory and you'll need to wait a few weeks to receive your result by post.

RESULTS

After a colposcopy, the doctor or nurse will often be able to tell you what they've found straight away.

If they take a biopsy (remove a small sample of tissue to be examined in a laboratory), you may need to wait 4 to 8 weeks to receive your result by post.

The biopsy samples will be sent off for testing. The results will give your doctor an idea of what steps they should take next.

The different types of abnormal biopsy results 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

If they're able to remove all the abnormal cells during the biopsy, you may not need more treatment.

They may also suggest one of the following options to remove the cells and prevent cervical cancer:-

Cone biopsy- Your doctor cuts a cone-shaped piece of tissue from your cervix to remove any precancerous cells. The abnormal cells are typically precancerous or cancerous.

Cryotherapy- Your doctor uses liquid gas to freeze abnormal cells from your cervix.

Loop Electrosurgical Excision Procedure (LEEP)- Your doctor removes abnormal cells with a wire loop that carries an electric current.

In rare cases, colposcopy and biopsy will find cervical cancer. If this happens, you'll be referred to a team of specialists to discuss treatment.

RISKS

Colposcopy is a common procedure with few side effects, however, you may be sore afterward.

After the surgery, your doctor may put a liquid bandage on your cervix to stop any bleeding. If they do, you can experience brown or black vaginal discharge. It could even resemble coffee grounds. It should clear up in a few days, so don't worry.

But call your doctor right away if you show any signs of infection, such as:

• Fever of 100.4 F or higher
• Heavy, yellow, stinky vaginal discharge
• Severe pain in your lower abdomen that isn't relieved by over-the-counter pain relievers
• Vaginal bleeding that lasts more than 7 days

There's always a risk that test results are incorrect. It's rare, but it happens. And there's a chance that abnormal cells can come back, even after your doctor removes them. That's why it's important to continue to get regular Pap smears and check-ups.