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Colposcopy

Published by Bupa's health information team, July 2009.

This factsheet is for women who are having a colposcopy, or who would like information about it.

A colposcopy is an examination of your cervix (the neck of your womb) using a special instrument called a colposcope.

Your care will be adapted to meet your individual needs and may differ from what is described here. So it's important that you follow your doctor's advice.

About colposcopy

A colposcopy is an examination of your cervix (the neck of the womb) using an instrument called a colposcope. A colposcope is like a big magnifying glass with a light attached.

You may need to have a colposcopy if you have had an abnormal cervical smear test result, or if you have symptoms of cervical cancer. A colposcopy allows your doctor to look at any abnormalities in more detail.

An abnormal cervical smear test result usually means that small changes have been found in your cervix. These changes are sometimes referred to as dyskaryosis or dysplasia. Changes in your cervix are also called cervical intraepithelial neoplasia (CIN). CIN isn't cervical cancer but an early warning stage. There are three grades of CIN, depending on how deep into the lining of your cervix it penetrates:

  • CIN 1 - mild changes to your cells
  • CIN 2 - moderate changes
  • CIN 3 - severe changes - this is sometimes referred to as carcinoma-in-situ (CIS)

A cervical smear test can show whether CIN is present but it can't always show the grade. A colposcopy is used to look more closely at the abnormal cells so that your doctor can determine the grade of CIN and therefore decide what type of treatment is best for you.

What are the alternatives to colposcopy?

If the abnormal cells on your cervix can't be seen properly with a colposcope, you may need to have a cone biopsy or LLETZ (large loop excision of the transformation zone) to remove the abnormal cells.

Preparing for your procedure

Your doctor will explain how to prepare for the procedure.

Some doctors prefer not to carry out a colposcopy if you have your period. Try to arrange your appointment for a date when you won't have your period. If you have your period on the day of the test, phone the hospital to check whether it's ok to go ahead.

If you're pregnant, or think you might be, let your doctor know. The colposcopy may need to be done in a slightly different way if you're pregnant.

About the procedure

A colposcopy usually takes between 15 and 30 minutes.

You will need to remove all clothing from the bottom half of your body. You will be asked to lie on your back on a special couch, with your feet drawn up and your knees apart. There will be padded supports for you to rest your legs on.

Your doctor will use a speculum (the same instrument that is used during a cervical smear test) to open up your vagina. He or she will look at the cells on the surface of your cervix through the colposcope. The colposcope will stay outside your body at all times.

Your doctor will gently wipe a solution of acetic acid (dilute vinegar) onto your cervix, using either a cotton wool ball or a spray. This will turn any abnormal cells white.

If no abnormal cells are found, you won't need any treatment.

If abnormalities are found, an iodine solution may be applied to your cervix so that your doctor can look at the cells more closely. The iodine solution will stain normal cells brown. Any abnormal cells will show up because they won't stain.

A small piece of your cervical tissue may be removed using a special instrument. This sample is called a biopsy. It will be sent to a laboratory to be examined.

If your doctor finds abnormal cells, you may be given treatment there and then to remove the cells before they can develop into cervical cancer. The most common type of treatment is called loop excision or LLETZ (large loop excision of the transformation zone). This isn't always done at the same time as the colposcopy - you may be given a separate appointment.

If you have loop excision treatment, a local anaesthetic will be injected into your cervix first. This will numb the area but you will stay awake during the procedure. A loop of fine wire with an electric current flowing through it will be used to remove the area of abnormal cells from your cervix. This takes around five to 10 minutes.

What to expect afterwards

You can usually go home when you feel ready.

You may have some bleeding from your vagina after the procedure. For this reason it's a good idea to bring a sanitary towel with you on the day of your colposcopy.

If you had a local anaesthetic, you may have some period-like pains as the anaesthetic wears off. You can take over-the-counter painkillers, such as paracetamol, to help reduce the pain.

Recovering from a colposcopy

You may have some blood-stained vaginal discharge after the procedure. This discharge shouldn't be any heavier than a period and should get progressively lighter. It will usually clear up within two weeks, but can sometimes last for up to six weeks. You may need to wear a sanitary towel during this time.

To help reduce the risk of getting an infection, don't go swimming, have sex or use tampons for around four weeks after the procedure. Your doctor will be able to give you some more specific advice.

Getting your results

Your doctor will discuss the general findings of the colposcopy with you after the procedure.

If you had a biopsy, the tissue sample will be sent to a laboratory for testing. You should receive the results within two weeks, but it can sometimes take longer. Your results will either be sent to you, or you will be given another appointment where a doctor will discuss them with you.

Your doctor may tell you what grade of CIN you have. In many cases of CIN 1, cells return to normal on their own. If you have CIN 2 or CIN 3, there is more risk of cervical cancer developing. You won't be diagnosed with cancer unless the abnormal cells break through the lining of your cervix into the tissue beneath.

You may need treatment to remove any abnormal cells. Cervical cancer can be prevented if the abnormal cells or the affected area of your cervix are removed. Your doctor will let you know whether you need treatment and what it will involve.

What are the risks

Colposcopy is commonly performed and generally safe. However, in order to make an informed decision and give your consent, you need to be aware of the possible side-effects and the risk of complications of this procedure.

Side-effects

These are the unwanted but mostly temporary effects of a successful procedure.

If you have a biopsy or treatment under local anaesthesia, you may have some period-like cramps as the anaesthetic wears off.

You may have some vaginal discharge and/or bleeding similar to a light period after the procedure. This usually clears up after about two weeks, but can sometimes last for up to six weeks.

Complications

This is when problems occur during or after the procedure. Most women aren't affected.

A very small number of women have some heavy bleeding after the procedure. If the bleeding seems heavier than a heavy period, contact the hospital or your GP immediately.

Rarely the biopsy site can become infected. Contact the hospital or your GP if you develop any of the following symptoms:

  • heavy bleeding
  • a fever (high temperature)
  • a vaginal discharge that smells unpleasant

The exact risks are specific to you and differ for every person, so we have not included statistics here. Ask your doctor to explain how these risks apply to you.

Related topics

Further information

Sources

  • Cervical cancer tests. Cancer Research UK. www.cancerhelp.org.uk, accessed 4 February 2009
  • Tests after an abnormal smear test result. Macmillan Cancer Support. www.cancerbackup.org.uk, accessed 19 February 2009
  • Abnormal cervical screening test results. Macmillan Cancer Support. www.cancerbackup.org.uk, accessed 21 April 2009
  • CIN (pre-cancer). Jo's Trust. www.jotrust.co.uk, accessed 21 April 2009
  • Cervical cancer screening. Cancer Research UK. www.cancerhelp.org.uk, accessed 21 April 2009
  • How cervical cancer is diagnosed. Macmillan Cancer Support. www.cancerbackup.org.uk, accessed 19 February 2009
  • Cervical screening Q&As. Macmillan Cancer Support. www.cancerbackup.org.uk, accessed 4 February 2009
  • Personal communication, Dr Shirin Irani, Consultant Gynaecologist & Honorary Senior Clinical Lecturer, Birmingham Heartlands and Solihull Hospitals, March 2009
  • Economou SG, Economou TS, Instructions for surgery patients. 1st ed. Philadelphia: W.B. Saunders Company, 1999:143-44,177-180
  • What can I expect at the colposcopy clinic? The British Society for Colposcopy and Cervical Pathology. www.bsccp.org.uk, accessed 4 February 2009
  • What is colposcopy? British Society for Colposcopy and Cervical Pathology. www.bsccp.org.uk, accessed 4 February 2009
  • Information. British Society for Colposcopy and Cervical Pathology. www.bsccp.org.uk, accessed 19 February 2009
  • Treating CIN. Macmillan Cancer Support. www.cancerbackup.org.uk, accessed 21 April 2009
  • Beers MH, Fletcher AJ, Porter R, et al, The Merck manual of medical information. New York: Pocket Books, 2003:1353-54
  • Colposcopy. Jo's Trust. www.jotrust.co.uk, accessed 26 February 2009
  • CIN (pre-cancer) treatment. Jo's Trust. www.jotrust.co.uk,accessed 26 February 2009
  • Colposcopy. eMedicine. www.emedicine.medscape.com, accessed 19 February 2009
  • After your treatment for abnormal cervical cells. Cancer Research UK. www.cancerhelp.org.uk, accessed 19 February 2009

This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for advice from a qualified health professional.

Publication date: July 2009

 

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