Colposcopy

Colposcopy is the inspection and examination of the cervix (neck of the womb) with a special instrument called Colposcope. This magnifies the cervix and allows the doctor to view and identify any abnormal areas on the cervix.

• Prior to the examination you will have a medical history taken.
• You will then be asked to lie on an examination couch, similar to    when you had your smear test taken at your GP or Family    Planning Clinic.
• A speculum is inserted into the vagina to expose the cervix.
• Special stains may be used to help identify abnormal areas on    the cervix and there could be slight brown discharge that day.
• At Colposcopy it is possible to determine whether there are    mild (CIN I) or more severe (CIN II/III) abnormalities of the    cervix. Depending on the type of abnormality, a course of    treatment will be explained to you.
• A biopsy (small sample of tissue from the cervix) may be taken.    However more often for CIN 11/111 you will be given the    option of having the treatment done at your first visit. We call    this “see and treat”.
• Occasionally a repeat smear test is taken. At a first colposcopy    visit swabs will be taken for infections of the vagina and cervix,    this includes a screen for Chlamydia infection.
• None of the procedure should be unduly painful.

TYPES OF COLPOSCOPY TREATMENTS AVAILABLE

In the case of mild abnormalities such as CIN I, your colposcopist may recommend that you attend for a further colposcopy in 6 months – many mild abnormalities of the cervix will revert to normal of their own accord.

One of the other options is to have a COLD COAGULATION treatment, which is a heated probe which destroys the abnormal cells.

On the other hand more severe abnormalities such as CIN II/III could progress to become cancerous in the future if they are not treated. The most common treatment carried out is a Large Loop Excision of tissue from the area of the cervix called the Transformation Zone (LLETZ). When this procedure is performed local anaesthetic is injected into cervix and a special loop is used to remove the area of abnormality tissue.

Following this treatment, the cervix will have a small wound which will heal over the following few weeks. Initially you may have some vaginal bleeding (however, at no stage should you have heavy bleeding, Pelvic pain, or pass large clots).
To prevent infection and allow healing to occur, you should avoid sexual intercourse and the use of tampons until the time of your next period.

Occasionally it is not possible to determine the grade of abnormality purely on Colposcopy alone. In this situation a biopsy (small sampling of tissue) will be taken from the cervix and sent to the laboratory for analysis. Depending on the results, a
treatment plan will be outlined to you.

WHAT TYPE OF FOLLOW UP WILL I NEED?

If you have had a LLETZ or cold coagulation procedure performed you will need to attend the Colposcopy Clinic again in 4- 6 months time to have a repeat Colposcopy, and/or smear test. This is very important because no matter what treatment you have there is a chance that abnormalities can recur. There is now a HPV DNA test available which can identify if there is HPV in your cervix. It is a particularly useful test to have after treatment as it differentiates between women who are at minimal risk of repeat disease and those who will need ongoing colposcopic follow up.

Usually you will then require a further assessment at 12 months.
If this assessment is normal, you will be seen on an annual basis or referred back to your G.P. However, in some circumstances where the biopsies have shown abnormal cells in the glands of your cervix, the follow up maybe more frequent.

CAN I STILL HAVE A COLPOSCOPY IF I HAVE A PERIOD?
If you are due a period please phone the nurse in advance to discuss your case. If you are on the Pill you can take two packs consecutively to prevent a period if it would coincide
with your appointment.

CAN A COLPOSCOPY BE PERFORMED IF SOMEONE IS PREGNANT?

You may have a Colposcopy while you are pregnant. If you think you are pregnant you should attend the clinic but tell the doctor or nurse when you arrive. Treatments for any abnormal cells will most likely be postponed until after your baby is born.