COLPOSCOPY
What is a colposcopy?
A colposcopy is currently the best method that we have to perform a closer examination of a woman’s cervix, vagina and vulva. The colposcope is basically a set of binoculars, connected to a light source, which allows a magnified assessment of the genital area.
You may be referred for a colposcopy for a few reasons. The most frequent reason is to gain further information after an abnormal Pap smear. A colposcopy is also often done to investigate other symptoms such as bleeding from the cervix, particularly after intercourse, and unusual vaginal discharge.
Abnormal Pap smear result & colposcopy
The cervix is constantly forming a new cell layer and there will be variations in the appearance of your cervix at different times of your menstrual cycle, as you get older, and sometimes as a result of medications that you are taking.
Sometimes the new cell development is abnormal, and it has become evident that in many cases these abnormalities are associated with a viral infection called HPV. The current method for detecting cervix and vaginal cell abnormalities is the Pap smear, although in the future a specific test for HPV will be used. Abnormalities are graded from minor to high-grade changes. For most low-grade changes, more frequent Pap tests are all that is needed for a period of time. However, if low-grade changes persist or if a high-grade abnormality was reported, a colposcopy will be needed.
What happens during a colposcopy?
During the colposcopy a speculum will be inserted into the vagina much like during a Pap test. Two solutions will then be used to wash your cervix [the first is weak acetic acid/vinegar, and the second is iodine]. Both of these solutions are used to highlight any abnormal areas, and aid a careful examination of your cervix to detect the location and pattern of any abnormal cells.
How can I prepare for a colposcopy?
A colposcopy cannot be performed while you are having your period. The entire examination takes about 15-20 minutes. Try to relax during the examination, but we do understand that it is a stressful time for you. We will do our best to make the experience as smooth as possible for you.
Is it painful?
Most women do not experience any pain, although you may have some discomfort from having the speculum inside your vagina for this length of time. If a biopsy sample is required, you may feel cramps, when we apply pressure to the cervix after the tissue is removed. You may wish to take some simple analgesia (paracetamol or ibuprofen) 1-2hrs beforehand.
Biopsy
If there are any areas of abnormality detected during the colposcopy, a biopsy [small sample of tissue] may be taken and sent to a laboratory for testing. It usually takes up to a week for the result to come back. Arrangements will be made for you to discuss the results when they are available and to arrange treatment, usually a LLETZ / wire loop excision, if required.
Aftercare
It is normal to have a little spotting for at least two days after a colposcopy, especially if you have also had a biopsy. It is a good idea to bring a sanitary pad with you to the consultation.
If a biopsy has been taken tampons and intercourse are best avoided until there is no vaginal loss. These precautions are aimed at reducing the risk of increased bleeding or infection. Spotting for any more than a few days is unusual and if this happens please contact the rooms for advice.
Is there anything else I should know?
Yes. If you are allergic to iodine you need to let the gynaecologist know before your procedure. You will also need to advise us if you are or think you may be pregnant. We would then advise on whether a colposcopy &/or biopsy is prudent.