Colposcopy

Published by Bupa’s Health Information Team, June 2011.

This factsheet is for women who are having a colposcopy, or who would like information about it.
A colposcopy is an examination to check for signs of cervical cancer. It uses a special instrument called a colposcope to look in detail at abnormal cells in the neck of the womb (cervix).

You will meet the doctor carrying out your procedure to discuss your care. It may differ from what is described here as it will be designed to meet your individual needs.

About colposcopy

Your GP or nurse may ask you to have a colposcopy if you have had a cervical smear test that showed abnormal cells, or if your cervix looked abnormal to the nurse or doctor doing the test.

An abnormal cervical smear test result usually means that changes have been found in the cells of your cervix. Abnormal cells found during cervical screening can be pre-cancerous. This doesn’t mean you have cervical cancer. It means that some of the cells are a little abnormal and if left untreated, they could develop into cervical cancer in the future.

Your GP may also recommend a colposcopy if you have symptoms such as bleeding in between periods or after sex, blood-stained vaginal discharge or pain in your pelvis. A colposcopy can help to show whether your symptoms are due to cervical cancer, or if they may be caused by something else.

In a colposcopy, your doctor will use an instrument called a colposcope to examine your cervix. A colposcope acts like a magnifying glass, which helps your doctor or nurse to see the cells of your cervix in detail and close up.

You may also have a small biopsy taken during a colposcopy. This means removing a sample of cells from your cervix. Depending on the results, your doctor or nurse may also be able to treat you during the colposcopy.

What are the alternatives?

If the cells on your cervix can't be seen properly with a colposcope, then your doctor may suggest other tests. The main alternatives are listed below.

• A cone biopsy. A small, cone-shaped section of abnormal tissue is taken from your cervix and is examined under a microscope. This is usually done under local anaesthetic.
• Large loop excision of the transformation zone (LLETZ). A wire loop with an electric current is used to remove abnormal areas of tissue. These are then sent to a laboratory to be checked.

Preparing for a colposcopy

A colposcopy is usually done in hospital as an outpatient procedure. This means you have the test and go home the same day. Some doctors prefer not to carry out a colposcopy if you have your period, so try to arrange your appointment for a date when you won't have your period. If you have your period on the day of the test, phone the hospital to check whether you can have the colposcopy or not.

What happens during a colposcopy

A colposcopy usually takes between 15 and 20 minutes. Your colposcopy may be done by a doctor or specialist nurse.

You will be asked to lie on your back on a special couch, with your feet drawn up and your knees apart. There may be leg or pedal rests to support your legs or feet.

Your doctor will use a speculum (the same instrument that is used during a cervical smear test) to hold open your vagina. He or she will paint your cervix with a liquid, such as acetic acid or iodine, which shows up any abnormal cells more clearly. A light is shone onto the cervix and your doctor or nurse uses the colposcope to look at the cells. The colposcope will stay outside your body at all times.

If your doctor or nurse sees anything that looks abnormal, a biopsy will be taken and the cells sent to a laboratory to be checked. You may be given a local anaesthetic to numb the area before the biopsy is taken.

If no abnormal cells are found, you won't need any treatment. If your doctor or nurse finds abnormal cells, you may be given treatment there and then to remove the cells before they can develop into cervical cancer. Alternatively, your doctor or nurse may ask you to come back for treatment at another appointment.

The most common type of treatment is LLETZ. Your doctor or nurse will inject a local anaesthetic into your cervix. This will numb the area so you won’t feel any pain. Some women may notice a stinging sensation when the anaesthetic is injected – this settles down very quickly. A loop of fine wire with an electric current flowing through it is used to remove the abnormal cells from your cervix. This takes around five to 10 minutes.

What to expect afterwards

You can go home when you feel ready.

If you have a biopsy taken, you may have some bleeding from your vagina after the procedure. For this reason it's a good idea to bring a sanitary towel with you on the day of your colposcopy.

If you have a local anaesthetic, you may have some period-like pains as the anaesthetic wears off. If you need pain relief, you can take over-the-counter painkillers such as paracetamol or ibuprofen. Always read the patient information that comes with your medicine and if you have any questions, ask your pharmacist for advice.

Recovering from a colposcopy

If you have treatment during your colposcopy, you should not go swimming, have sexual intercourse or use tampons for around four weeks after the procedure. You may also be asked to have showers rather than a bath for between two and four weeks. This is to decrease the chance of developing an infection or bleeding. Your doctor will be able to give you more specific advice.

If you have a biopsy, the tissue sample will be sent to a laboratory for testing. Your doctor or nurse will tell you when to expect the results. You may need to come back to the hospital for an outpatient appointment, or you may get your results by post.

You may need further treatment to remove any abnormal cells. Your doctor will let you know whether you need treatment and what it will involve.

What are the risks?

As with every procedure, there are some risks associated with colposcopy. We have not included the chance of these happening as they are specific to you and differ for every person. Ask your doctor to explain how these risks apply to you.

Side-effects

These are the unwanted but mostly temporary effects you may get after having the procedure.

Having a colposcopy may be uncomfortable because you need to lie in a certain position for the procedure. It’s not usually painful, but you may feel some discomfort if you have a biopsy taken.

If you have a biopsy or treatment under local anaesthesia, you may have some period-like cramps as the anaesthetic wears off. You may also have some blood-stained vaginal discharge similar to a light period. This usually clears up after about two weeks, but can sometimes last for up to six weeks. You may need to wear a sanitary towel during this time. If you’re bleeding heavily or the bleeding gets worse, see your GP or contact the colposcopy clinic for advice.

Complications

Complications are when problems occur during or after the procedure. Most women aren't affected.

A very small number of women have some heavy bleeding after the procedure. This is more likely to happen if you’re pregnant when you have the colposcopy, or if a large biopsy is taken. If the bleeding seems heavier than a heavy period, contact the hospital or your GP immediately.

The place where a biopsy was taken can become infected, though this is rare. Contact the hospital or your GP if you develop:

• heavy bleeding
• a fever (high temperature)
• a vaginal discharge that smells unpleasant

For answers to frequently asked questions on this topic, see Common questions.

For sources and links to further information, see Resources.