Having a colposcopy

What is a colposcopy?

A colposcopy is an examination to check whether there are abnormal cells on your cervix (neck of the womb), and if so, how serious they are. These changes are caused by certain types of human papillomavirus (HPV) infection. Colposcopy usually takes place in an out-patient hospital clinic

Why do I need a colposcopy?

You have been asked to come for a colposcopy because your cervical smear test has shown evidence of abnormal cells. This procedure determines the cause of the abnormalities and lets the doctor/nurse colposcopist decide if you need treatment.

Abnormal cells are not unusual – about one in 12 smears is abnormal and it usually means small changes have been found in cells on the cervix. These changes are known as dyskaryosis and act as early warning signals that cervical cancer might develop in the future.

It is very rare for these abnormalities to be cancer. For some women the changes in the cervix return to normal by themselves, other women need simple out-patient treatment. There is a 95% chance that the abnormality will be cleared. However, there is small possibility that it might persist at a lower grade (with borderline or mild cell changes). Treatment does not guarantee that you will no longer have an HPV infection.

How is a colposcopy done?

The colposcopist will take a close look at your cervix using a magnifying lens with a light (a colposcope). They may take a small tissue sample (a biopsy) to check any areas of your cervix which look unusual. If the colposcopy confirms there are abnormal cells on your cervix, you may need to have to have them removed to help prevent cervical cancer.

Before your procedure

If you would like a female nurse or doctor to carry out your colposcopy, please call the clinic to request this when you receive your appointment on the number below.

If you think you might have your period on the day of your appointment, you should call the clinic to arrange a different time. 

To make it easier to look at your cervix during your colposcopy, please do not have sex or use vaginal medications, lubricants, or creams for at least 24 hours beforehand.

You should bring a panty liner to your appointment as you may have a small amount of vaginal discharge after your colposcopy. If you have a small tissue sample taken (a biopsy), you may also experience some light bleeding.

During the procedure

You will need to undress from your waist down and lie down on a bed with your knees bent.  You will be asked to place your legs onto some padded supports. You will have a paper sheet or towel to cover your stomach and hips. The examination takes about 10 to 15 minutes.

Just like at your screening test, the nurse or doctor will put a speculum (a smooth, tube-shaped tool) into your vagina and open it gently. They will then use a colposcope to take a close look at your cervix. The colposcope does not go inside you, or even touch your skin.  It stays about 30cm (12 inches) outside your vagina. The image of the cervix from the colposcope will sometimes be on a screen. This helps the nurse or doctor see your cervix more clearly.

They will dab different liquids onto your cervix with a cotton bud or small sponge. The liquids make any abnormal cells a different colour so that they can be seen more easily. If the nurse or doctor finds anything unusual they may take away a small tissue sample (a biopsy). The biopsy will then be checked in the laboratory.

The examination can feel uncomfortable and rarely, some people may feel some pain. If it feels painful, tell the nurse or doctor and they will try to make it more comfortable for you.

The nurse or doctor may be able to tell you what they have found straight away. If you have had a biopsy taken, it will need to be checked in the laboratory. If this happens, you will get your results by post about four weeks later.

After your colposcopy

Most people feel well enough to go about their day-to-day activities straight away, but some may need to go home and rest for a while. You may have some brownish discharge from your vagina from the liquids that were used during your colposcopy.

For the next few days, you may have some light bleeding from your vagina, especially if you have had a biopsy. This is normal and usually stops after three to five days. It’s best to avoid sex, using tampons, and any vaginal medications, lubricants or creams until the bleeding stops to prevent any infection.

Training

The Royal Free London is a teaching hospital so sometimes student doctors or nurses may be present during your clinic appointment. Although attending these clinics is part of their training, it is your choice if you wish them to be present. Whatever your decision, your treatment, and the standard of care you receive will not be affected.