You will be referred for colposcopy if your cervical smear test shows that you have high-grade changes, or you continue to have low-grade changes

Colposcopy is an examination of the cervix and the vagina using a colposcope. The colposcope is like a pair of binoculars on a stand. It is placed near the entrance of the vagina and makes the cervix appear larger. A liquid is wiped onto the cervix so that areas with abnormal cells show up.

The doctor may take a small sample of tissue (about the size of a match head) from areas that look abnormal. This is called a biopsy. It may be uncomfortable but will be discussed with you. The tissue sample will be sent to the laboratory to be examined under a microscope.

Why do I need a colposcopy?

What happens at the clinic?

What happens during a colposcopy?

What happens after a colposcopy?

Is colposcopy safe?

Does it always work?

How do I get my results?

Colposcopy results

What happens if I need further treatment following colposcopy?

What happens after a woman has had treatment?

 

Why do I need a colposcopy?

You have been asked to come to a colposcopy clinic because there were abnormal cells on your cervical smear.

Abnormal cells on a cervical smear hardly ever mean cancer. Many women have an abnormal smear result at some time in their lives. However the abnormal cells may develop into cancer if they are not treated.

When you have a colposcopy the doctor will be able to see the cells on your cervix and tell if you need treatment.

It is very important to have the colposcopy to find out how much the cells on your cervix have changed, so you need to keep this appointment.

If you have to change the time, please phone the clinic as soon as possible.

If you think you will have your period on the day of your appointment, please phone the clinic for another time. The doctor cannot see your cervix clearly if you have your period.

If you are pregnant it is safe to have a colposcopy, but make sure you tell the clinic nurse.

If you need an interpreter, please let the clinic know in plenty of time.

You are welcome to have your partner, a family or whānau member or a friend with you for the whole clinic visit.

 

What happens at the clinic?

First, the doctor or nurse will ask you questions about your health. They will want to know the first day of your last period. This is a good time for you to ask questions. You will then have the colposcopy, which takes about 15 minutes.

The doctor who will see you has been specially trained as a colposcopist. A nurse will be there to help you the whole time. The whole visit may take over an hour. If you need to know more about your visit, ask the clinic staff.

 

What happens during a colposcopy?

A colposcope is used for looking at cells on the vaginal wall and cervix (the neck of the womb). The colposcope makes the cells appear larger, so they can be seen more easily.

You will be asked to lie on a raised bed with your legs up in leg rests. The colposcope will be put near the opening to your vagina. It will not touch your body.

The doctor will insert a speculum in the same way as when you have a cervical smear test. That makes it easier for the doctor to see your cervix through the colposcope.

This kind of examination can be embarrassing but the doctor and nurse will try and make you comfortable.

The doctor paints a liquid onto your cervix. This shows up any abnormal cells as white areas. The liquid may sting a little but it is not harmful.

Usually the doctor will take some small tissue samples (biopsy) from areas that look abnormal. The pieces of tissue are the size of a match-head. When the tissue is taken you may feel a quick, sharp pinch. Afterwards, you may have the sort of pain you get during your period.

The biopsy is sent to a laboratory, to find out exactly what sort of changes are taking place. Unless you disagree, the results of the biopsy will be sent to the NSCP-Register.

 

What happens after a colposcopy?

After the colposcopy the doctor will talk to you briefly about what he or she saw. If you need to take the rest of the day off work, please ask the staff for a medical certificate.

You may have some cramps. Rest and do what you usually do when you have period pain. The biopsy will leave a small raw area on your cervix. You may bleed a little bit or have some reddish discharge from your vagina. You may see a small scab come away.

The discharge from a small biopsy like this will only last a few days.  Until it stops and your cervix is healed:

• use sanitary pads, not tampons
• have showers instead of baths
• avoid sexual intercourse
• avoid spa pools and swimming pools.

If you start to bleed more than you do when you have your period, or if the bleeding goes on for more than a week, call the colposcopy clinic.

 

Is colposcopy safe?

There are very few risks in having a colposcopy. On very rare occasions a woman may feel unwell or bleed more than is usual and may need to seek medical advice if she is concerned about this. 

A colposcopy does not affect your chances of getting pregnant or having a child in the future.

 

Does it always work?

A colposcopy is an effective way of finding abnormal cells. Very occasionally the colposcopy may have to be done again because the biopsy results were not clear. Colposcopy does not always detect tiny abnormalities.

 

How do I get my results?

It takes two to4 weeks for the clinic to get the results from the laboratory. The doctor or nurse will tell you how the clinic will send those results to you. You will get either a phone call or a letter.

Once the results are back the doctor can advise you if you need treatment or a follow-up colposcopy and smear. Your results will also go to the GP or smear taker who referred you to this clinic.

 

Colposcopy results

Occasionally the biopsy result will be normal. Usually the biopsy results will show how much the abnormal cells have changed the surface of the cervix. CIN (Cervical Intraepithelial Neoplasia) is the word to describe how much change there has been. CIN is also sometimes called dysplasia.

There are three grades of cell change:

• CIN 1 Mild abnormality
• CIN 2 Moderate abnormality
• CIN 3 Severe abnormality, (also known as carcinoma in situ).

None of these is cancer.

Cells that have only changed a little (CIN 1) usually change back to normal by themselves. Cells that are more abnormal (CIN 2 and CIN 3) may turn into cancer over a number of years if they are not treated.

It is very rare that a colposcope shows someone has cancer. If this happens, you will be referred to a cancer specialist.

Early treatment of abnormal cervical cells has a 98 percent – 100 percent success rate.

 

What happens if I need further treatment following colposcopy?

The type of treatment depends on where abnormal cells are found, the number of them, their size and how much change there has been. The doctor will discuss with you your choices of treatment and where they are available.

Treatment methods include:

• LLETZ (Large Loop Excision of the Transformational Zone): This treatment uses an electrical wire loop to remove abnormal cervical cells under local anaesthetic.
• Laser Treatment: heat from a laser beam is used to remove or destroy abnormal cervical cells under local anaesthetic.
• Diathermy: heat is used to destroy abnormal cervical cells under anaesthetic
• Cone biopsy: a cone-shaped section of the cervix containing the abnormal cells is surgically removed under anaesthetic. 

The specialist who carries out the treatment will explain what kind of care needs to be taken afterwards.

The above treatments for abnormal cells on the cervix will not affect a woman’s ability to become pregnant.

On rare occasions after a cone biopsy, the cervix may be weakened.  This can lead to an increased risk of miscarriage or premature delivery.

Hysterectomy as a treatment for abnormal cells: a total hysterectomy is a major operation to remove the uterus and cervix under anaesthetic.  Normally, there is no need to have a hysterectomy solely because abnormal cervical cells are present.  Some women choose this option for treatment because they have other problems, such as heavy bleeding, for which a hysterectomy might be recommended.

 

What happens after a woman has had treatment?

Another colposcopy should be carried out in four to six months after treatment to check it was effective in removing all abnormal tissue.   A cervical smear will be taken at the same time.