Your doctor may have referred you to see us for a Colposcopy. Commonly, this is following an abnormal pap smear result. Abnormal results are not uncommon – it happens in 1 in 20 tests.
What is an ‘abnormal’ pap test?
Abnormal pap test or dyskaryosis means there are changes to the normal cells on the cervix or the neck of the womb. These abnormal cells acts as an early warning sign that if left unchecked, might develop into cervical cancer in the future. Pap smears act as screening tests to detect these abnormalities, and if present, for further evaluation and treatment to be arranged.
What is Colposcopy?
This is an examination using an instrument with magnifying binocular lenses and a powerful light source. It allows your doctor to have a closer look at the cervix to determine if abnormal changes are present on the cervix as a result of dyskaryosis.
The process is similar to having a pap smear. Once you’re lying comfortably, a clean speculum is inserted into the vagina which helps gently move the vaginal walls apart so that the cervix can be seen clearly. The colposcope is positioned outside your body and your doctor uses this to look at the cervix with greater magnification. The procedure is painless, but some may find it uncomfortable.
Having a Colposcopy:
Coming to your appointment for a colposcopy
- Please ensure you have a valid referral, preferably with your latest pap smear results from your GP
- You may wish to bring a family member or friend to accompany you.
- If you are due for your period at the time of your appointment, please let us know
- Dress comfortably. You will need to remove your lower clothing for the examination
- We provide sanitary pads for your use at the end of the examination, but you are very welcome to bring your own if you wish.
Before your examination
- Your doctor will take a thorough history and ask you some questions relating to your periods, abnormal bleeding, the use of any contraception, previous pap smear results, smoking history, and enquire about your general health.
- You will be asked to undress from your waist downwards.
During the Colposcopy examination
- Our nurse will help position you on the examination couch.
- A warmed speculum is inserted into the vagina and the pap test is usually repeated
- A small amount of a very weak vinegar solution (acetic acid), is dabbed onto the surface of the cervix. This is to help identify any areas of abnormal cells, which will appear white and can be easily seen by the magnifying lens of the colposcope. The solution can cause a minor stinging sensation which quickly subsides.
- A brown solution (Schiller’s Iodine) may be used at times to further enhance the identification of abnormal cells.
- Your doctor may spend a few minutes studying the abnormal cells (if present) with the aid of the colposcope.
- If any abnormal cells are identified, a biopsy will be taken. A small amount of tissue, roughly the size of a pinhead is obtained. You may feel some cramps and discomfort which will usually subside quickly.
- There may be a small amount of bleeding from the biopsy site and your doctor will dab this area gently with a chemical cue-tip (silver nitrate) or a brown, pasty substance (Monsel's paste) to help stop the bleeding
After the examination
- Your doctor will discuss your colposcopy findings and will arrange to see you after 2 weeks to discuss the results of your pap smear and biopsy.
- You may have some bleeding but it should stop within a couple of days. It should never soak a pad with large clots – if this happens please call our rooms immediately or present to the Emergency Department at LGH.
- Avoid intercourse, tampon use or swimming for 5-7 days. This allows the biopsy site to heal.
Results and Treatment Plan
The colposcopy examination defines the type and extent of the abnormal area on the cervix. It helps determine if you need further treatment, and what sort of treatment is needed. The biopsy result usually confirms the type of abnormality present.
If your test results return showing high grade lesions (e.g. CIN 2 or CIN 3 or glandular abnormalities, you will need a minor operation at a later date to remove these abnormal cells.
Very rarely, a cervical cancer is diagnosed at the time of colposcopy and biopsy.
If you need treatment for high grade cervical abnormalities, we will arrange for your treatment at either the Launceston General Hospital or Calvary St Vincent’s Hospital.
Follow up after treatment
If you underwent an operation to remove the abnormal cells on the cervix, we will see you in 6 months for a repeat colposcopy and pap smear. The aim of this visit is to ensure your cervix has healed well and to check if any residual dyskaryotic cells still present.
Your doctor will discuss any follow up visits you may need.