Colposcopy at Highgate Hospital

What is a colposcopy?

A colposcopy is a closer examination of your cervix, the opening to your womb from your vagina, using a lighted magnifying instrument called a colposcope. The colposcope stays outside your body the whole time. It may also be used to check your vagina and vulva.

Why might I need a colposcopy?

Your doctor may refer you for a colposcopy if:

• your cervical screening (smear test) found changes to your cervical cells linked to human papillomavirus (HPV)
• you've had a high-risk HPV result on 3 screening tests in a row, even without cell changes
• it hasn't been possible to get a clear result after several screening tests
• you have symptoms such as unusual vaginal bleeding, for example after sex, between periods, or after the menopause.

What are the benefits of a colposcopy?

• It lets a gynaecologist doctor or nurse look much more closely at your cervix than is possible during a standard screening test
• Most people who have a colposcopy do not have cervical cancer, and it can offer reassurance that your cervix looks healthy
• If abnormal cells are found, they can often be removed during the same appointment, which lowers your future risk of cervical cancer
• Treatment to remove abnormal cells has a high success rate, around 90%.

Are there different types of colposcopy?

The examination itself is generally the same for everyone. However, if abnormal cells are found, you might have treatment to remove them during the same appointment, or you might need to come back for a separate visit, depending on what's found and how much tissue needs removing.

How do I prepare for a colposcopy?

In the 24 hours before your appointment:

• avoid penetrative vaginal sex, and avoid using tampons, vaginal creams or other products inside your vagina
• contact the clinic in advance if you think you'll be on your period, if you're pregnant or think you might be, or if you'd like an interpreter
• bring a pad or panty liner, as you may have some minor bleeding afterwards
• if you have a coil (IUD or Mirena), let the team know; it doesn't usually need to be removed.

What happens during a colposcopy?

Here's what typically happens:

1. You'll be asked to undress from the waist down, behind a screen, and lie down with your legs supported. A female chaperone will be present with you and for assistance to the clinician if required.
2. A speculum, a smooth tube-shaped tool, is gently placed in your vagina to hold it open, similar to a cervical screening test.
3. The colposcope, a lighted magnifying instrument, is used to look closely at your cervix; it stays outside your body throughout.
4. A liquid is dabbed onto your cervix to help show up any abnormal cells; this can cause a mild tingling or stinging feeling.
5. If needed, a small tissue sample (biopsy), about the size of a pinhead, may be taken; this can feel like a mild pinch or scratch.
6. The whole appointment usually takes around 15 to 20 minutes, though you may be at the hospital for longer overall.

What happens after a colposcopy?

You can usually go home soon after and rest. You might have mild pain, similar to period pain, for a few days, which painkillers such as paracetamol can help with.

Some bleeding and discharge is normal too. If you only had the examination, this usually settles within a few days, though it can last up to 4 weeks if you had treatment such as LLETZ.

While this settles, avoid penetrative sex, tampons or menstrual cups (use pads instead), and vigorous exercise. Contact a GP or call 111 if you have heavier bleeding than a normal period, smelly discharge, or pain that doesn't improve with painkillers.

If no abnormal cells were seen, you'll usually be told straight away. If you had a biopsy, results typically take up to 4 weeks by post, with a copy sent to your GP.

What are the risks of a colposcopy?

• The procedure can feel uncomfortable, and some people find it painful. You can ask for it to be stopped at any time
• There's a small chance of getting a vaginal infection afterwards
• There's a small chance of heavy bleeding, particularly if you have treatment such as LLETZ at the same time.