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Colposcopy
What is a colposcopy?
A colposcopy is a simple procedure to examine the cervix, the lower part of the uterus at the top of the vagina. It is often performed if abnormal cells are found in your cervix during cervical screening.
These cells often disappear on their own, but occasionally there is a risk that they will develop into cervical cancer, if they are not dealt with. A colposcopy can confirm if cells in your cervix are abnormal and determine if you need treatment to eliminate them.
When do I need a colposcopy?
You may be referred for colposcopy within a few weeks of your cervical screening if:
- some of the cells in your screening sample showed up abnormal
- the nurse or doctor who performed the screenings considered that your cervix does not look as healthy as it should
- it was not possible to give you a clear result after several screening tests were done
- A colposcopy can also be used to find out the cause of problems such as unusual vaginal bleeding (for example, bleeding after sex).
Try not to worry if you have been referred for a colposcopy. It is very unlikely that you have cancer, and the abnormal cells will not get worse while you wait for your appointment.
Cervical screening (a smear test) checks the health of your cervix. The cervix is the opening to your womb from your vagina. It’s not a test for cancer, it’s a test to help prevent cancer.
Utilizing DYSIS - The Next Generation Colposcope with an Advanced Cervical Scan.
DYSISmap is an adjunctive technology to assist colposcopy The DYSIS Colposcope is a high resolution digital colposcope with an adjunctive map. The DYSISmap is generated by a proprietary technology that measures the aceto-whitening reaction and summarises it in the form of an intuitive map. The DYSISmap is overlaid on the live image of the cervix to help with the identification of the most relevant biopsy sites.
A high resolution view of the cervix is presented on the touch-screen monitor. The image can be magnified and blue or green filters can be applied. Additionally, DYSIS has a High Contrast mode that is particularly useful to help with the identification of abnormal blood vessels or other morphological features.
The unique feature of the DYSIS Colposcope is that it accurately measures the reaction of the cervical epithelium using a proprietary technology called Dynamic Spectral Imaging. The results are summarised in the DYSISmap that is overlaid on the live image of the cervix. The inclusion of the DYSISmap information with the standard colposcopic indications can assist with the identification of cervical disease.
You can read more about DYSIS here: DYSIS Colposcope
DYSIS is an incredible addition to women’s healthcare. I have already identified areas of concern with the DYSIS mapping, which would have been overlooked with the naked eye. The standardization of the entire process gives me reassurance that there is enough acetic acid applied and enough time passed during the exam to get the best results. My patients are also much more at ease seeing what I see in real time.
DYSIS informational video
DYSIS Testimonials
What happens during a colposcopy
The procedure is usually performed in a hospital clinic. It takes about 15 to 20 minutes and you can go home the same day.
During the procedure
- you will undress from the waist down (a loose skirt may not need to be removed) and lie on a chair with padded supports for your legs
- a speculum is inserted into your vagina and carefully opened
- a microscope with a light is used to look at your cervix – your body is not touched or stepped on during this procedure
- fluids are applied to your cervix to highlight abnormal areas
- A small sample of tissue (a biopsy) may be taken to a lab for closer examination – this can be a little uncomfortable
If it is obvious that you have abnormal cells in your cervix, you may receive treatment to remove the cells right away. If it is not clear, you will need to wait until you get the results of the biopsy.
Results of a colposcopy
It’s often possible to tell you right away if there are any abnormal cells in your cervix. But if you had a biopsy, it may take 4 to 8 weeks to get your results in the post. The result of the procedure and/or biopsy will be either:
Normal result
Normal – about 4 out of 10 people have no abnormal cells and are advised to continue going for cervical screening as usual
You will be advised to continue cervical cancer screening as usual, in case abnormal cells develop later.
Depending on your age, you will be invited for a cervical screening appointment in 3 or 5 years.
Abnormal result
abnormal – about 6 in 10 people have abnormal cells in their cervix and may need treatment to remove them
The different types of abnormal biopsy results and their significance are as follows:
CIN 1 – the cells are unlikely to become cancerous and may go away on their own. No treatment is needed, and you will be invited for a cervical screening test in 12 months to check if they have disappeared.
CIN 2 – there is a moderate risk of the cells becoming cancerous, and treatment to remove them is usually recommended
CIN 3 – there is a high chance that the cells will become cancerous, and treatment to remove them is recommended
CGIN – there is a high chance that the cells will become cancerous, and treatment to remove them is recommended
Your doctor or nurse may use the term CIN or CGIN when discussing your biopsy result. This is the medical term for abnormal cells. It is followed by a number (for example, CIN 1) that indicates the likelihood that the cells will become cancerous. A higher number means a higher risk of developing cancer if the cells are not removed.
Treatments for the removal of abnormal cells
Treatment to remove abnormal cells is advised when there is a moderate or high risk that the cells will become cancerous if left untreated. There are several simple and effective therapies that can be used to remove the abnormal cells, including:
Large loop excision of the transformation zone (LLETZ) – a heated wire loop is used to remove the aberrant cells
A cone biopsy – a cone-shaped piece of tissue containing the abnormal cells is cut out of your cervix
The LLETZ is usually done while you are in a state of wakefulness, but your cervix will be anesthetized. You can go home the same day. A cone biopsy is usually done under general anesthesia (where you are asleep) and you may need to stay in the hospital for the night.
After the colposcopy treatment
You can often go back home and have a rest soon after your treatment. Most people feel well enough to return to work and most normal social activities the next day.
You are usually advised to avoid the following
- Driving for at least 24 hours if you had a general anesthetic – if you had a local anesthetic, you can drive again right away
- Using tampons or menstrual cups for 4 weeks (use sanitary napkins instead)
- not have sexual intercourse for 4 weeks
- Exercise, including swimming, for at least 2 weeks, or while bleeding or discharge is still present
You are also advised to have another cervical exam test 6 months after treatment to check for abnormal cells and human papillomavirus (HPV).
If no HPV is found, you will not need to be tested again for 3 years. However, if HPV or significant cell changes are found, you will be referred for another colposcopy.
Risks and side effects
The common side effects of the procedure are:
- mild pain, similar to menstrual pain – this should pass in a few hours and can be relieved with acetaminophen or ibuprofen
- Mild vaginal bleeding and brown, watery vaginal discharge – this can last up to 4 weeks
There is also a small risk of more serious complications, such as:
- an infection – this can cause severe or persistent bleeding, smelly vaginal discharge, and persistent abdominal pain; see a doctor if you have these symptoms
- A slightly increased risk of premature birth (before 37 weeks of pregnancy) in future pregnancies – this is more likely if you need repeated treatments or a lot of tissue needs to be removed
In most cases, the benefits of treatment will outweigh these risks. Talk to a doctor or nurse if you have concerns or want to know more about the possible risks of treatment.