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Colposcopy

A colposcopy is an intimate test to take a look at your cervix (the neck of the uterus), vagina and vulva (the outer part of the female genitalia).

A colposcopy appointment is usually made if the results from your smear test show abnormal cells in your cervix caused by the human papillomavirus (HPV).

These cells are not cancerous, but if they are not treated, there is a risk they could turn into cervical cancer.

Contact Gynaecology Clinic

You may also be offered a colposcopy if you have had several smear tests that have shown you have HPV but no abnormal changes to your cells, or to find out the cause of symptoms such as unusual vaginal bleeding.

A colposcopy can diagnose:

  • Genital warts
  • Noncancerous growths
  • Inflammation of the cervix (also known as cervicitis)
  • Precancerous changes in the tissue of the cervix or the tissue of the vagina
  • Precancerous changes of the vulva

It’s very rare to find cervical cancer during a colposcopy.

If you have been invited to have a colposcopy, it’s normal to feel anxious.

There are many useful resources available online that can help manage difficult feelings. If you would like some support, it’s worth visiting:

Reading Well, which is designed to help you manage your health and wellbeing with useful books.

Understanding Anxiety, which has a huge number of links to online tools and internet-based self-help resources.

You could also consider downloading a mindfulness app, such as Headspace or Calm, which you could even listen to during your colposcopy.

Before

Prior to your colposcopy, you may have had one or more smear tests. If this test picked up abnormal cells or your tests showed the presence of HPV, you will have been invited to have a colposcopy.

When you schedule your appointment, you should avoid a picking date where you may be on your period.

Good to know

  • For all intimate examinations and tests, we offer the presence of a chaperone. The chaperone will be a female nurse or a female trained member of staff.
  • If you would prefer a female doctor, please let us know.

From two days before, you should also not have vaginal intercourse, use a tampon or any vaginal medications or creams.

Before coming to your appointment, it’s a good idea to take some pain-relieving medication, such as paracetamol or ibuprofen. It’s a good idea to bring some pain-relief and sanitary pads to your appointment.

During

On the day of your appointment, you will need to go to our Outpatients Department as your procedure will take place in one of our consultation rooms. Your doctor will start by explaining the procedure and answering any questions you may have.

Once you’re ready, you will need to undress from the waist down. The doctor will lock the door to prevent people entering, draw a privacy curtain, and wait on the other side until you are ready. A chaperone will also be present in the room at this point to help you feel comfortable.

Your doctor will then ask you to lie on your back on a couch and place your feet in stirrups, with your knees up.

Your doctor will then place a device called a speculum (which is a tube-shaped tool) into your vagina. Once in place, the speculum opens to allow a clear view of your cervix. If this hurts too much, don’t hesitate to tell your doctor, so they can use a smaller speculum.

The doctor will then position an instrument called a colposcope (which is a magnifying instrument with a light) a few inches away from your vulva. This will allow the doctor to examine the cervix and vagina. The colposcope will not touch you. In order to examine the cells more closely, your doctor will also gently swab your cervix and vagina with a cotton bud to remove any mucus and may also apply a vinegar-based solution, which will highlight areas that need further investigation. This may cause a burning or tingling sensation.

If your doctor sees tissue they are unsure about, they will use a sharp instrument to take a small sample of tissue for further examination. Sometimes multiple small samples may be taken from different areas. When a tissue sample is taken for examination, it is called a biopsy. If you have had a biopsy, your doctor will also apply a chemical solution to the area to help stem any bleeding. Your doctor may also take some photographs to help with further investigations.

Some issues can be treated during your colposcopy. For example, if your doctor sees a small area of abnormal cells, this could be removed during your colposcopy. This is done with a ‘Large Loop Excision of the Transformation Zone’ (LLETZ), also known as a loop cone, loop biopsy or loop excision. An LLETZ takes 5-10 minutes and involves using a heated wire to remove abnormal cells. This is done under local anaesthetic, so the area being treated is numb.

A colposcopy is mostly uncomfortable but some women may find it very painful, particularly if they also had a biopsy. Fortunately, the procedure does not take long and usually lasts 10-15 minutes. You can expect your entire appointment to take 20 to 30 minutes, including preparation time. If at any point you feel too uncomfortable during the procedure, make sure to tell the doctor, so they can give you something to help with the pain, or stop the procedure entirely.

After

After a colposcopy, it’s normal to experience some mild cramping or spotting for the next day or two.

If you also had a biopsy, you may experience:

  • Pain over the next two days
  • Light bleeding for one or two days
  • Dark vaginal discharge

You should also not use tampons or have vaginal intercourse for one week after, or for as long as your doctor recommends.

If you had an LLETZ:

You will bleed after the procedure and you may have some light bleeding for up to four weeks after.

After an LLETZ you should:

  • Not use tampons for four weeks
  • Avoid sex for four weeks
  • Not exercise for two weeks, or while there’s still some bleeding or discharge

Before you leave your appointment, your doctor will let you know when you can expect your results, so you can book a follow-up appointment before going home. This could be in-person or remotely.

After a colposcopy, and particularly if you also had a biopsy or treatment, we would recommend taking a taxi home or asking someone to drive you home in case you do not feel well afterwards.

It’s a good idea to have some pain-relief, pads and a hot water bottle ready at home to help with pain, cramps or discomfort.

Results

Depending on your results, you could doctor may recommend further treatment.

This could involve:

Cryotherapy: This is where abnormal cells are destroyed by freezing.

Laser ablation: This involves using a laser to pinpoint and destroy the cells.

Cone biopsy: This is a minor operation that involves surgically removing the affected area of your cervix.

Cold coagulation: Despite its name, this involves applying heat to the cervix to burn away abnormal cells.

Total hysterectomy: This is the surgical removal of the uterus. This is only ever considered if abnormal cells on your cervix have been found more than once or if they’re severely abnormal.

If you have had any treatment, you should have a smear test six months after to check everything is ok.

Medically reviewed by Mr Emeka Okaro - MBBS FRCOG on 17/01/2024

How to pay for your treatment

If you’re… paying for yourself

Did you know you don’t need private medical insurance to come to St John & St Elizabeth Hospital? As a self-pay patient, you can access safe, outstanding quality health care at times to suit you.

For scans and tests, as well as to see most consultants, you’ll still need to be referred by a medical professional like your GP, but as a self-pay patient, the process is more straightforward. You won’t need authorisation from an insurance provider, and you’ll have greater choice of consultant and appointment times.

If you’re… insured

St John & St Elizabeth Hospital is approved by all major medical insurance companies. If you have a personal private health insurance policy, or your company provide it for you, you can use it to pay for your care from your initial consultation through to treatment, surgery and aftercare such as physiotherapy. Not all private health insurance plans cover the same things. It’s very important to check exactly what you are covered for with your insurance provider.