If you’ve recently had abnormal or ‘positive’ results from your routine cervical screening, or pap smear, you will likely be referred for a colposcopy. The first thing you need to do is try not to worry. It can be scary to be referred for more tests and we understand it is easy to assume the worst but a colposcopy referral doesn’t mean you have cervical cancer.
Less than 1 woman in 1,000 referred for a colposcopy is found to have cervical cancer requiring immediate treatment. The whole point of regular cervical screenings is to catch cell changes as early as possible as these changes can occur many years before cancer develops, if at all, and getting them early means treatment can be provided to prevent cancer from developing.
It is also worth noting that colposcopies are not limited to detecting cancerous cells, they are also used where previous pap smears did not yield readable results, to investigate unexplained bleeding or if your gynaecologist thought your cervix did not look as healthy as expected.
What happens during a colposcopy?
Dr Bailey will explain the procedure and will answer any questions you may have on the day. The procedure is not too dissimilar to your pap smear; a speculum will be inserted and gently hold your vagina open to allow us to look more closely at your cervix.
A microscope (colposcope) with a strong light, resembling a pair of binoculars, will be used to look at your cervix. The colposcope doesn’t enter your body; it stays outside and allows Dr Bailey to see the cells on your cervix on a screen. Different liquids may be dabbed onto your cervix to stain abnormal cells so they can be seen more clearly. You may feel a mild burning sensation when the liquid is applied to your cervix but if this causes you pain we will make you feel more comfortable before continuing.
Should we find abnormal cells we may take a small biopsy for testing. This shouldn’t be painful but if necessary, we may administer a local anaesthetic to numb the area. This procedure will take 5-10 minutes on an outpatient basis.
If a biopsy is taken you will get the results within 2 weeks.
About 60% of women referred for a colposcopy are found to have abnormal cells but it is important to remember that this doesn’t mean the cells are cancerous. The idea is to catch and treat these cells before they have the opportunity to become anything more menacing than just abnormal.
Some mild abnormalities will not require treatment but should treatment be needed, the aim will be to remove the abnormal cells.
The most common treatment is a large loop excision of the transformation zone (LLETZ). This involves using a heated wire loop (diathermy) to remove the abnormal cells. Although, this 10-minute procedure can be performed on an outpatient basis, Dr Bailey prefers to perform the procedure under a light general anaesthetic.
After the procedure, you will need close follow up to ensure the abnormal cells are gone. This involves another colposcopy and Pap smear a few months later.
After your colposcopy
Post-appointment you should be able to continue with your daily activities but for a few days after you may have vaginal discharge or light bleeding. This is quite normal and usually stops after three to five days. It is recommended that you wait until any bleeding stops before having sex or using tampons, lubricants or vaginal creams.
Being referred for a colposcopy can be worrisome but we’re here to help and are pleased to report that the removal of abnormal cells has a high success rate (about 90%). If you have any questions about colposcopies or treatments for abnormal cervical cells please get in touch.