A Colposcopy is a procedure where the lining of the cervix (the neck of the womb) is closely examined. It is carried out by a colposcopist (a specially trained doctor or nurse) who uses a magnifying instrument called a colposcope to check the cells that line the cervix for abnormalities.
A Colposcopy is carried out when the results of a cervical screening test indicate that there are abnormal changes in the cells of the cervix.
Modern Colposcopy clinics are fitted with video equipment that allows the colposcopist to view the examination on a television monitor. The patient can also watch the procedure if they want to, which may help to reduce any nervousness and anxiety.
After closer examination of the cervical cells, the colposcopist will be able to determine the extent of any cell abnormalities and whether any treatment is required.
If the Colposcopy confirms that there are cervical cell abnormalities, a biopsy may be carried out. This involves removing a small sample of tissue for closer examination and testing.
The treatment of abnormal cervical cells is almost always 100% successful. Following treatment, it is unlikely that any cell changes will occur in the future.
A colposcopy is sometimes used to investigate a problem or condition other than abnormal cervical cell changes. For example, a colposcopy may be used to investigate:
- unexplained vaginal bleeding
- an abnormal appearance of the cervix after an examination
- an inflamed cervix (cervicitis)
- postcoital bleeding(bleeding related to intercourse)
- genital warts found on the cervix
Some of the available treatments are discussed below.
1) Large loop excision of the transformation zone (LLETZ)
In the UK, large loop excision of the transformation zone (LLETZ) is the most common treatment for abnormal cervical cells.
LLETZ can sometimes be carried out at the same time as a colposcopy and involves cutting out the area of the cervix where the abnormal cells have developed. This is done using a thin wire loop that is heated with an electric current. The loop is also used to seal the wound.
LLETZ usually takes 5-10 minutes. It is often carried out under local anaesthetic (medication that numbs the area). The procedure is not usually painful, although you may feel some pain that is similar to period pain.
If a larger area of the cervix needs to be treated, the procedure will take longer and you may need a general anaesthetic (where you are put to sleep).
You will need to bring a sanitary towel with you as you will bleed after having LLETZ. You may also have some light bleeding for several weeks after the procedure.
After having LLETZ you should avoid:
- using tampons for four weeks after LLETZ (use sanitary pads instead)
- having sexual intercourse for four weeks following LLETZ
- heavy exercise
These all increase your risk of developing an infection after the procedure has been carried out.
2) Cone Biopsy
It is not possible to carry out a cone biopsy at the same time as a colposcopy. A cone biopsy is a minor operation that usually requires an overnight stay in hospital.
A cone biopsy is carried out under general anaesthetic. A cone-shaped piece of tissue is cut away from your cervix. The section of tissue that is taken may include the whole area of cervix where the abnormal cells are located. The tissue will be sent to a laboratory for closer examination under a microscope.
It is normal to bleed for up to four weeks after having a cone biopsy. You may also have some period-like pain, although any discomfort should only last for a couple of hours. Painkillers can be used to help ease the pain.