Colposcopy

What is Colposcopy?

Colposcopy is a simple outpatient clinic procedure to examine the cervix. As an experience, it is very similar to having a smear test performed. During colposcopy, the cervix is visualised using a speculum and is examined under magnification and bright light to look for signs of any abnormality.

Two dyes are applied to the cervix (acetic acid and iodine) which highlight the abnormality if present. From the colposcopy appearance, the abnormalities can also be graded as low grade (CIN1) and high-grade changes (CIN2-3).

Colposcopy examination is carried out by a specialist gynaecologist who is accredited by the British Society of Colposcopy and Cervical Pathology (BSCCP). A nurse will also be present and you will be given an option to see your cervix on the screen.

Why is a colposcopy performed?

A colposcopy is often performed following an abnormal smear. It allows the specialist to assess the cervix and grade any abnormalities if present.

Sometimes, a colposcopy is performed for assessment of certain symptoms such as bleeding after sex OR persistent vaginal discharge OR if your GP is concerned about the appearance of your cervix.

Does it hurt?

Colposcopy as an experience is very similar to having a smear test. There may be some discomfort involved with the insertion of a speculum, but you should not experience sharp pain. If you find smears uncomfortable, he/she will be able to use a smaller speculum or a numbing gel called Instillagel. If a biopsy is needed, it may also be carried out after the application of local anaesthetic.

What happens in a colposcopy appointment?

During the consultation a detailed medical history will be obtained. You will also have an opportunity to ask the specialist any questions that you may have.

A nurse is always present during the colposcopy examination and will assist you. A speculum examination is performed to visualise the cervix and a colposcope is used to assess it under high magnification. As explained above, two solutions are used to highlight abnormal areas if any. A biopsy may be obtained from these areas after application of local anaesthesia.

We offer colposcopy packages for self pay patients to keep costs low and transparent.

How soon can I return to work?

An examination will usually take 30 minutes. The colposcopy itself will take 5-7 minutes and you will be able to go home or back to work straight away. If you have had a cervical biopsy you may experience some light vaginal bleeding whichcan last up to 48 hours. In addition, some women report some mild lower abdominal discomfort but this will not usually stop you returning to your daily activities.

What will the colposcopy show?

The examination may show a normal cervix or low grade or high grade changes. Your specialist will explain the findings. Depending on your clinical circumstances, you may or may not need treatment.

What does the treatment involve?

The commonest form of treatment is LLETZ (Large Loop Excision of Transformation Zone). It is also known as LEEP (Loop Electrosurgical Excision Procedure, an American term). This is commonly carried out as an outpatient procedure under local anaesthesia. After numbing the cervix with local anaesthetic, a heated wire loop is used to remove the abnormal cells. It is a quick procedure that takes approximately 10 minutes. Similar to having a biopsy, some women report discomfort, but no sharp pain…

Please refer to this special page on treatment for further information.

What is CIN?

CIN is an acronym for Cervical Intra-epithelial Neoplasia. These are pre-cancerous changes within the cervical epithelium (lining cells of the neck of womb). There are three grades of CIN (CIN1,2&3). CIN2 & CIN3 are high grade changes and are often treated to prevent future risk of cervical cancer. CIN1 (low grade changes) will often resolve spontaneously and a period of observation is often advised. There are various ways of treating CIN, but the common options. are:

• LLETZ (Large Loop Excision of Transformation Zone): Also known as LEEP (Loop Electrosurgical Excision Procedure, an American term). This information mainly relates to this procedure.

• Cone Biopsy (Extended or deeper excision): Carried out by Laser, Knife or Needle.

When will I get the results of my colposcopy?

Your specialist will discuss the colposcopy findings with you. The results will usually be ready within 10 days.

If I have my period, should I cancel my appointment?

There is no need for cancelling a new colposcopy appointment or treatment appointment as a period will not interfere with the colposcopy assessment. However, if a smear test is also required (as in a follow up colposcopy appointment), then it may be better to avoid it during a period.

Do I need a GP referral letter?

GP referral letters are not needed unless you are claiming your visit on insurance and your insurer requires one. However, GP referral letters are helpful because they provide your information and history so if you do have one please bring it with you to your appointment.

Can I swim after a colposcopy?

Yes, it is safe to go swimming after a colposcopy unless you have had a biopsy or treatment.

Is there anything I should avoid after a colposcopy?

• Nothing if only a colposcopy is performed.

• If a biopsy is also taken, it is best to avoid intercourse, bathing and swimming for 3-4 days. It is ok to shower.

• If you are seen for a colposcopy and treatment, then you should avoid intercourse, swimming, bathing, using tampons or strenuous exercise for a period of 4 weeks.

Where can I find out more information or access any useful support services?

Read our colposcopy patient information leaflet.

If you wish to learn more about our colposcopy pricing, patient feedback and services we offer, visit see our colposcopy procedure page.

To learn about Treatment of CIN, see our patient information leaflet.

For further information please visit our specialist website London Colposcopy.

For further information, advice and support visit Jo’s Trust, the UK’s only cervical cancer charity dedicated to women, their families and friends affected by cervical abnormalities and cervical cancer, and includes information about colposcopy.

To learn about gynaecological cancer, visit the Eve Appeal; the UK’s leading national charity funding research and raising awareness into the five gynaecological cancers – womb, ovarian, cervical, vulval and vaginal.