Colposcopy

What is a colposcopy?

It means looking at the cervix (neck of the womb) with a special type of magnifying instrument, which is called a colposcope. It may be possible for you to see the examination on television. It will take about 20 minutes altogether.

Why am I going to the colposcopy clinic?

When you had your last smear, the report showed that the cervix (neck of the womb) needed closer inspection.

Does the colposcope go inside me?

No, definitely not. The magnifying instrument and its light are only on the outside. The only thing to go inside – so that the cervix (neck of the womb) can be seen, is a speculum – which is the same as when you have your smear taken.

Will I be asleep during the examination?

No, you will be awake during the examination and the Doctor and nurse are present throughout the procedure.

What is the difference between a Colposcopy and smear test?

Firstly, you are asked to sit in a chair with supports for your legs, you don’t have to take all your clothes off, only your underwear – or you can wear a gown if you prefer. Secondly, a thicker piece of skin will be taken from the neck of the womb. This is called a biopsy and is about this size O.

Won’t that hurt?

Many women wouldn’t notice the biopsy. The actual biopsy is likely to be no more than a bit uncomfortable. However, you can take two Paracetamol or your normal painkillers before you leave home if you wish.

Why is all this being done?

It is part of a screening programme to ensure the cervix stays healthy. Your smear test has shown some changes in the cells. In many cases they return to normal without treatment but sometimes the changes become worse and could lead to cancer in the future. We sometimes call these cells ‘early warning cells’. As there is no way at present of knowing whose cells will get better or worse, it is wise to monitor everyone who has these changed cells, as a preventative measure.

What if I am having a period?

If you are having a period then the examination may not be possible so please phone the Consultant’s secretary on 020 8449 7624. If you are not having a period please make a note of when you had your last period. We also need to know what medication you are on and your current contraception.

Will I bleed afterwards?

You may pass a small amount of blood afterwards. This normally stops in a few days but you may continue to have a slight discharge. You may prefer to bring your own sanitary towel to wear afterwards. We advise against tampons. You may also be advised not to have sexual intercourse for a few days. Please go to the toilet before being called into your appointment.

Do I need to starve?

No, you do not. In fact we recommend that you have a good breakfast or lunch.

What happens at Colposcopy?

You will be asked to lie on a special couch which supports your legs. Then a speculum is passed so that we can look at the cervix (neck of the womb). This is just like having a smear test. The cervix is then painted with a solution of acetic acid (which smells a bit like vinegar). This helps us to identify any abnormal cells that might be present. We may then paint a different solution on the cervix, which is brown. This is a solution containing iodine. When it is put on the cervix, it will make some areas stain black and others yellow. This too also helps us identify any abnormal cells. Then we will take a biopsy. This is carried out using special biopsy forceps, which look like a bird’s beak. These remove a small piece of tissue with minimal discomfort. If you wish to, you may watch to whole procedure on television. We may also screen for infection and STDs.

Do I need to take time off work?

We advise you to take the morning or afternoon off, when your appointment is scheduled. Some people feel more comfortable taking the whole day off, but we leave this to your discretion.

Smoking

There is a relationship between smoking and abnormal cells on the cervix. So, if you are a smoker, please consider giving up or cutting down. There is some evidence to suggest that even partners smoking may have an effect. Treatment Depending on the results, you may be advised to have treatment (Loop Diathermy/LLETZ) to remove the abnormal cells under local or a short general anaesthetic. You will be then advised to avoid intercourse and tampons for 3 weeks. You will usually be followed up with smear and/ or colposcopy tests at 6 month intervals for a year with your consultant and then yearly smears, usually with your GP

Important Notes

If you are taking Warfarin or other anti-coagulants (blood thinning agents) you should liaise with your doctor/surgeon prior to your procedure to discuss whether these need to be temporarily stopped. If in doubt please do not hesitate to ask.

Nitu Bajekal , Updated Feb 2009