The Colposcopy Clinic

What is a colposcopy?

A colposcopy is an examination of the cervix (neck of the womb) using a colposcope. This looks like a pair of binoculars on a stand. It does not go inside you, but allows the doctor or nurse to see the cervix in more detail. The examination will take place in the colposcopy clinic at your local hospital.

A colposcopy can be done safely during pregnancy. However, if you need treatment, this is usually postponed until 12 weeks after the end of your pregnancy.

A colposcopy can be done if you have a coil (IUD). There is a small risk that a coil might need to be removed at your appointment. You should either not have sex, or use another contraceptive method (e.g. condoms) for at least seven days before your appointment.

Why do I need an appointment?

You may have had a smear result showing abnormal cell changes known as dyskaryosis. This is not unusual - about 1 in 10 smears are abnormal. This may mean that a few cells are at risk of becoming cancerous in the future. It is unlikely that these abnormalities are cancer.

Your last three smears may have been inadequate. This does not mean that abnormal cells have been found, but means that it was not possible to check from your smear test if the cells are healthy, so further examination is required. About 1 in 50 smears are inadequate.

You may have been sent to the clinic for an examination because you have bleeding or discharge, even though your smear test was normal.

Your GP or clinic doctor or nurse may want us to examine the appearance of your cervix in more detail.

Please contact the clinic if you are unable to attend so that your appointment can be used by someone else. You will then need to make another appointment for yourself. You should let the clinic know if you have any allergies (e.g. to latex) or serious medical conditions. Please contact the clinic before you attend for your appointment.

What will happen at the clinic?

When you go to the clinic please report to the clinic clerk or receptionist, who will check your details. There may be no childcare facilities at the clinic. If you need to cancel or rearrange your appointment, please phone the number on your clinic letter. You are welcome to arrange for a relative or friend to go with you.

If you are having your period on the day of your appointment and you have regular periods, please ring to make another appointment. If you have irregular periods or are bleeding all the time, please keep your appointment.

You will be seen by either the nurse or doctor who will explain the reason for your appointment before you are examined. It is helpful to know the date of your last period.

What happens during the examination?

You will need to remove your underwear. The colposcopy nurse will help you position yourself on a special couch or bed which will support your legs. A speculum (the instrument your doctor or nurse used when you had your smear taken) is placed inside your vagina. A smear test may be repeated. Different liquids are dabbed onto your cervix, which help to show up any abnormal areas. The doctor or nurse will look at these areas using the colposcope.

In some clinics you are able to watch your examination on a TV monitor. With your permission, your Colposcopist can use the camera to take a picture of your cervix to store with your hospital records.

Sometimes a small piece of tissue may be taken from the surface of your cervix. This is called a biopsy. You may feel a slight stinging for a few seconds. You may be offered treatment at your first visit. This will be explained to you at the time, but you may wish to bring somebody with you just in case, as some clinics may not offer treatment if you attend on your own.

An examination takes about 10 to 15 minutes and treatment may take a little longer, but allow more time for the whole visit.

What can you tell from the colposcopy?

The doctor or nurse may be able to tell you what is wrong at the time of the examination and what treatment, if any, you need. Often they will need to wait for the results of any tests.

What does treatment mean?

LLETZ (sometimes known as DLE, DLB or Loop biopsy) removes abnormal cells using a small wire loop. This is sometimes done at the first visit.

Laser treatment uses a beam of light to destroy abnormal cells.

Cold coagulation, cryocautery and diathermy destroy abnormal cells using a probe placed on the cervix.

These are all usually done in the clinic. You may have a local anaesthetic, which numbs the cervix.

A few women need a cone biopsy - this removes a small area of the cervix and you usually need a general anaesthetic (you would be asleep).

If treatment is needed, you will be offered the best treatment for you.

Who needs treatment?

If your results show CIN (cervical intra-epithelial neoplasia - sometimes called pre-cancerous cells), you may be advised to have treatment.

CIN is divided into three types - CIN1, CIN2 and CIN3. In CIN1 there is only a very slight change in the cells and this type often goes back to normal on its own without any treatment. In CIN2 and CIN3 there are more changes which need treatment to prevent cervical cancer developing in the future, as they are less likely to return to normal on their own. Your doctor or nurse will advise you whether treatment is needed.

Does the treatment work?

Treatment is nearly always 100% successful. However, a small number of women treated may need more treatment. As a result, it is very important to have regular follow-up.

Following the examination

After a colposcopy examination you should feel well enough to continue with your usual routine. However, if you have treatment, you may need to take things easy for the rest of the day. If you feel unwell after the visit you should not drive until you have recovered.

If you have had a biopsy taken you may notice a bloodstained discharge for a few days. Wear sanitary pads rather than tampons to prevent infection. You should avoid sex for about seven days.

If you have had treatment, you will need to avoid sex and use of tampons for four weeks. You should avoid swimming until any discharge has stopped.

If you notice a heavy blood loss, vaginal discharge or severe pain please contact the clinic or, if out of hours follow the advice given by the colposcopy clinic. Before you leave the clinic make sure you know how and when you will receive your results and what numbers to contact if you have any questions or problems.

Will I need follow-up?

This will depend on whether your smear was abnormal, what is found on any biopsies, and whether you need any treatment.

Your Colposcopist will explain what follow-up you need, either at the time of your appointment, or in a letter when your results are available.

I didn't come to my appointment - what will happen?

It is important that you are seen in the clinic. Please contact the clinic or your doctor if you cannot attend to arrange a new appointment. If you have not informed the clinic, you will be sent one further appointment. If you do not attend this you will NOT be sent another appointment.

If you do not attend two appointments and do not contact the clinic, you will be contacted by the local Nurse Co-ordinator and your GP will be informed. You can be referred back at any time by your GP or Nurse Co-ordinator.

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