Colposcopy

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Overview

Colposcopy
Colposcopy
  • A colposcopy is a test to take a closer look at your cervix. The cervix is the opening to your womb from your vagina.
  • A colposcopy is often done if cervical screening finds changes to your cells that are caused by certain types of human papillomavirus (HPV). These changed cells can turn into cervical cancer cells.
  • During a colposcopy a smooth, tube-shaped tool (a speculum) is gently placed into your vagina to open it. A microscope is then used to look at your cervix in greater detail. The microscope stays outside your body.
  • A small sample of cells may be taken from your cervix for testing. This is called a biopsy.

Why it's done

Why a colposcopy is done

A colposcopy is often done if a smear test (cervical screening) finds abnormal cells in your cervix caused by human papillomavirus (HPV).

These cells are not cancer, but there's a risk they could eventually turn into cervical cancer if not treated.

You may be offered a colposcopy after getting the results of your cervical screening (smear test) if:

  • the results of your smear test showed changes to the cells of your cervix
  • it was not possible to get a clear result after several screening tests

A colposcopy can also be used to find out the cause of other symptoms such as unusual vaginal bleeding (for example bleeding after sex).

Try not to worry if you are invited to have a colposcopy.

It’s very rare to find cervical cancer during the procedure.

If you are feeling worried or concerned, you may find it useful to talk to a charity such as:

Getting ready

If your cervical screening results show that abnormal cervical cells linked with human papillomavirus (HPV) were found, you will get a letter inviting you for a colposcopy.

You will be given your appointment time in your letter. You may have to wait 8 weeks or more.

The procedure will usually take place at a colposcopy unit at a local hospital or clinic.

Contact the hospital or clinic before your appointment if:

  • you think you will be having your period at the time of your appointment as your appointment may need to be rescheduled
  • you’re pregnant or think you may be pregnant – it is safe to have a colposcopy when pregnant, but you need to tell the hospital or clinic before you attend your appointment
  • you’d like someone to be in the room with you (a chaperone), for example someone you know, a nurse or member of staff
  • you need an interpreter

Getting ready for a colposcopy

For the 24 hours before your colposcopy:

  • do not have penetrative vaginal sex
  • do not use any products that you place inside your vagina, such as tampons, vaginal creams or medicines

You might have some minor bleeding after the colposcopy, so it’s a good idea to bring a sanitary pad or panty liner to the appointment.

If you have a coil (IUD, or Mirena coil) it does not usually need to be taken out, but tell the person doing the colposcopy that you have one.

What happens?

What happens during a colposcopy

A colposcopy is usually carried out in a hospital or clinic. It should usually take 15 to 20 minutes to have your colposcopy and you should be able to go home afterwards.

But you might be at the hospital for several hours from getting there to going home.

When you arrive at the hospital or clinic, you'll speak with a nurse about what's going to happen during the colposcopy.

They will ask you some questions about your general health and your medical history.

Giving consent

A nurse or doctor will explain the possible risks of having a colposcopy.

The procedure is very safe, but afterwards there is a small chance of:

  • getting a vaginal infection
  • heavy bleeding

If anything like this does happen, the healthcare team will be there to look after you.

You'll be asked to sign a consent form. This is to confirm that the procedure and the risks have been explained to you, and you agree to have the colposcopy as discussed with medical staff.

The procedure

A colposcopy is usually done by a specially trained nurse (colposcopist). Sometimes it may be done by a doctor.

Before the procedure you will be asked to remove your clothes, behind a screen, from the waist down. You may be given a sheet to cover yourself.

If you wear a loose skirt or a long jumper, you may be able to keep this on during the procedure.

You will be asked to lie down and put your legs on a padded support.

A colposcopy should not be painful, but it can sometimes feel uncomfortable. You can ask for the procedure to be stopped at any time.

What happens/What it might feel like

  • A smooth, tube-shaped tool (a speculum) is gently placed into your vagina to open it. A microscope with a light attached (colposcope) is then used to look at your cervix. The colposcope does not go inside your vagina - You may feel a little uncomfortable, but you should not be in any pain
  • The doctor or nurse will put liquids on your cervix. These liquids help them see any abnormal cervical cells - You may feel a mild tingling or stinging sensation when the liquids are used
  • A small tissue sample, around the size of a pin head, may be removed for testing. This is known as a biopsy - You may feel a mild pinching or scratching sensation as the tissue is removed

Further treatment

If the doctor or nurse finds abnormal cells in your cervix, they may recommend removing them. This will reduce your risk of cervical cancer.

They may do this treatment on the same day as your colposcopy, or you might be asked to come back for another appointment.

LLETZ (large loop excision of the transformation zone)

The most common way to remove abnormal cells is using a procedure called large loop excision of the transformation zone (LLETZ).

LLETZ is often done at the same time as your colposcopy. You will not need to stay in hospital and can go home the same day.

You will first have an injection of local anaesthetic to numb your cervix so you should not feel any pain.

A heated loop of wire is then used to remove the tissue. An area of tissue about the size of a fingernail is removed. LLETZ takes around 15 minutes.

Let the doctor or nurse know if you feel any discomfort during the procedure. You may need more local anaesthetic.

If you have a coil (IUD or Mirena coil) the doctor or nurse will try not to cut the threads. But if this happens the coil can still be removed safely without the threads when needed.

Cone biopsy

If the doctor or nurse needs to remove a large piece of tissue, they may recommend a cone biopsy. This involves removing a cone-shaped section of tissue from your cervix.

You will be asked to make a follow-up appointment for this procedure.

You will be put to sleep (general anaesthetic) for the cone biopsy and for this reason you may need to spend the night in hospital afterwards.

After a colposcopy

You can often go home to rest soon after the treatment is finished.

After a colposcopy you may have some mild pain, similar to period pain, for a few days. Taking a painkiller such as paracetamol can help.

You are also likely to have some bleeding and discharge from your vagina. If you had a colposcopy only, then the bleeding and discharge may pass after a few days.

If you had a biopsy or LLETZ

If you had a biopsy or LLETZ (large loop excision of the transformation zone) the bleeding can last longer. After LLETZ, some people have bleeding for up to 4 weeks.

If you have any bleeding, discharge and pain:

  • do not have penetrative sex or put anything inside your vagina – if you had LLETZ you may be told to avoid sex for 4 weeks
  • do not use tampons or menstrual cups, use sanitary pads instead
  • avoid activities that could make the bleeding or pain worse, such as vigorous exercise that makes you breathe hard and fast

Non-urgent advice:Contact a GP or call 111 if:

After a colposcopy you have:

  • heavy bleeding from your vagina which is more than you would expect during a heavy period
  • unpleasant smelly discharge from your vagina
  • stomach pain that does not get any better after taking painkillers or keeps coming back

Results

Getting your colposcopy results

If no abnormal cells were found, then you will usually be told straight away by the doctor or nurse.

You will still need to attend routine cervical screening appointments in the future.

If you had a biopsy you may need to wait 4 to 8 weeks to get your results.

Understanding your biopsy results

Your biopsy may not find any abnormal cells. This is known as a normal result. Depending on your age, you'll be invited for a cervical screening appointment in 3 or 5 years if you get a normal result.

Or your biopsy may find abnormal cervical cells. This is known as an abnormal result. It’s not cancer, but there is a risk the cells could turn into cancer in the future if not treated.

Doctors use the following terms for abnormal cervical cells:

  • cervical intra-epithelial neoplasia (CIN)
  • cervical glandular intra-epithelial neoplasia (CGIN)

Results-Risk-Recommended treatment

  • CIN1 - Low risk - No immediate treatment is needed. You may be offered a follow-up cervical smear test or colposcopy to check the cells
  • CIN2 - Medium risk - You may be offered a follow-up colposcopy to check the cells or treatment to remove cells
  • CIN3 or CGIN - High risk - You will be offered treatment to remove cells

In rare cases, a colposcopy and biopsy will find cervical cancer. If this happens, you'll be referred to a team of specialists to discuss treatment.

Support is available

Most of the time a colposcopy will not find anything to worry about.

But it might help to speak to someone if you're feeling worried about your results, or if you are told you have cervical cancer.

You can get in touch with charities such as:



The information on this page has been adapted by NHS Wales from original content supplied by NHS UK NHS website nhs.uk
Last Updated: 21/05/2024 10:38:37