Why will I need a colposcopy?
Colposcopy is a procedure performed in the office (no anaesthetics required) to examine abnormal cells in the cervix, vagina or vulva. In most cases, a colposcopy is performed due to an abnormal Cervical Cancer Screening test result. It may also be performed due to unusual or unexplained vaginal bleeding, or an abnormal lump or growth on the cervix or vagina. Typically, a colposcopy is not performed to diagnose cervical cancer. It diagnoses abnormal cells that may be the first signs of cancer that may develop years later.
How is a colposcopy performed?
A colposcopy takes approximately 10 to 20 minutes and is performed in the clinic. You will remain awake during the procedure.
You do not need to prepare for this procedure. It should be scheduled for when you do not have your period. A colposcopy is safe to perform when pregnant.
You will be asked to lie on your back with your feet in supports. The gynaecologist will gently insert a speculum into the vagina (similar to a cervical screening test) which holds open the walls of the vagina. Then they will use a microscope and light (called a colposcope) to view inside the cervix with magnification. The colposcope does touch you and remains approximately 20cm to 30cm away from the vagina. The image on the right shows the colposcope being used by a gynaecologist.
The gynaecologist will then apply one or two types of liquid onto your cervix. One of the liquids is acetic acid (vinegar) and the other is Lugol’s solution (containing iodine). Both liquids will stain the cervix and highlight any abnormal cells. Both liquids may sting slightly.
Typically, a small biopsy is taken from an area that looks abnormal.
How long will the results take to become available?
The specialist performing the colposcopy should be able to generally explain what was seen and how you will receive your results. If a biopsy was taken during the colposcopy, it will be submitted for pathology testing and examined under the microscope. This may take a week and your doctor may ask you to return to the clinic to discuss the findings.
What are the risks of a colposcopy?
Colposcopy is a safe procedure with minimal risks. However, the following may occur:
- The application of the liquids may cause a burning, tingling or stinging sensation. The liquids may also smell.
- The biopsy may be uncomfortable but should not cause heavy pain.
- After the biopsy, the doctor will apply a paste to the local area to stop the bleeding. This paste may cause a mildly burning sensation.
- After the examination, you can leave the practice and return to your normal daily activities. Typically, no painkillers are required, and you can drive. For a couple of days, a brownish discharge is possible. Please wait to have intercourse until after the discharge settles.
- If you bleed significantly, please let your doctor know.
Further testing and treatment
Pending the outcomes of the colposcopy and the biopsy, the possible outcomes are:
- Doing nothing for now and repeat the test after a few months. Sometimes that is the best solution for changes that are mild and are likely to disappear by itself.
- A LLETZ or cone biopsy. This is a day surgical procedure conducted under general anaesthetic to excise a cone-shaped portion of the lower part of the cervix. This procedure is for women who have suspected precancerous changes on the cervix.
- If your specialist is concerned about the possibility of cervical cancer, you will be offered a referral to a gynaecological oncologist (such as Prof. Obermair) who will take over your care.
Pictured: Colposcopy allows the specialist to visualise abnormal cells on the cervix (here stained white and bright yellow) that could not be visualised without colposcopy.