Colposcopy – Glengarry Private Hospital, Perth
Colposcopy – Summary
Discomfort is similar to a smear test
1. A simple examination to check for abnormalities pf the cervix.
2. Colposcopy is very frequently performed in Perth and Australia.
3. The consultation & colposcopy together take about 30 minutes.
4. Colposcopy itself is no more uncomfortable than having a smear.
5. If biopsies are needed, then some women find these uncomfortable – but some don’t.
5. Areas that are severely abnormal need to be removed at a subsequent appointment.
6. Smears & colposcopy reduce the chance of getting cancer of the cervix in the future.
Call us to arrange a consultation • Perth (08) 9448 9822
Colposcopy – Introduction
Colposcopy is a very frequent part of our work in our specialist clinic at Glengarry Private Hospital, Perth. In Perth, probably 20% of women will have a colposcopy in their lifetime, most commonly after an abnormal PAP smear. The word colposcopy simply means “examination of the cervix”.
The main point of the colposcopy examination is to look at the cervix, using a special microscope, and find abnormal cells. These abnormal cells are usually picked up on a PAP smear. Other reasons for colposcopy are that we may need to look at the cervix if there has been some abnormal bleeding eg. bleeding after sex (post-coital bleeding), or if it’s felt the cervix looks unusual.
Colposcopy – more information
Colposcopy allows us to see the cervix and see abnormal cells in great detail by magnifying the cervix using a microscope. We first look at the cervix under plain magnification. We then use a green light filter to examine the blood vessels in detail. The way they look and branch can give important clues about abnormality.
Following this, the cervix is painted with one, or sometimes two, types of fluid (acetic acid & aqueous iodine) to show up the abnormal cells. A judgement is made about how severe the changes to the cells are. We also judge whether we can see all the abnormal areas containing the cells picked up on the abnormal PAP smear.
Sometimes the cells shown on the abnormal PAP smear may be up inside the cervix. Since they aren’t visible this can lead to difficulties in assessment. Occasionally abnormal cells are visible outside the cervix at the top of the vagina.
Possible further tests done during or after colposcopy include:
- a targeted PAP smear (usually a cytobrush or ThinPrep or SurePath smear that is more accurate than the normal PAP smear)
- small biopsies (very straightforward)
- larger excisional biopsies that remove all the abnormal cells picked up on the PAP smear and seen at the examination
These larger biopsies are usually done under either local anaesthetic, usually in the operating theatre at Glengarry, Perth. General anaesthetics can also be provided (and are sometimes preferred) again at Glengarry.
Why do I need a colposcopy test?
You may have been referred to us at Glengarry Private Hospital, Perth for a colposcopy for any of the following reasons:
- An abnormal PAP smear test result.
- An abnormal area appearing on the cervix, vagina or vulva.
- Bleeding from the cervix, especially bleeding after sex.
Dr Sillender will discuss, before the colposcopy, why you have been referred, and why the colposcopy is necessary.
What does having an abnormal Pap smear test result mean?
When the scientists who examine smears looked at your PAP smear in the lab, they saw cells that looked “different” from normal cells. An abnormal PAP smear test result may indicate the presence of
- HPV (Human Papillomavirus). This extremely common infection can grumble on & give inflammation which gives a slightly low grade appearance on your PAP smear.
- Low grade abnormal change. This is the next step up and again is due to inflammation causing a reaction to the cells on the cervix. Usually it will settle with time, but high grade change does need to be ruled out with colposcopy.
- High grade abnormal change. High grade change is a pre-cancer. In other words, if it were left, it might develop into cancer of the cervix. This can almost always be sorted out simply, as long as we see you in good time.
- Bacterial infection. Swabs and antibiotics can be helpful in diagnosing & clearing abnormal PAP smear changes due to infection.
- Aging. Thin skin seen in older women can get infected causing changes that mimic pre-cancerous changes.
- “Normal” inflammation or cervicitis. Often this mild irritation settles down by itself with no treatment.
Does an abnormal smear mean I have cancer of the cervix?
An abnormal PAP smear result or referral for a colposcopy examination does not mean you have cancer.
Very few women with abnormal smear test results have cancer (but it does need to be ruled out). The PAP smear test is to detect abnormal cell changes and have them removed before cancer develops.
How is a colposcopy done?
It is very similar to the Pap smear test. We have a dedicated room in our offices at Glengarry in Perth, with an electric couch. You relax back on this couch and our nurse covers you up with sheets. We place a speculum into the vagina to look at the cervix – just like a PAP smear test.
We then examine the cervix with the colposcope. Another targeted smear may be taken. A solution is applied to the cervix and vagina. Any abnormal areas are examined with the colposcope. The colposcope does not enter your body. The examination usually takes about 10 minutes. Biopsies (if needed) may take a little longer.
Will a biopsy (a small tissue sample) be done at the colposcopy?
If any abnormal areas are seen, a biopsy or small tissue sample may be taken during the colposcopy. You may feel a pinch when the biopsy is taken, but you may not feel any discomfort at all. Silver solution is applied to the biopsy site afterwards to help stop any bleeding. Afterwards wear a pad until any bleeding or discharge stops.
What happens after a biopsy of the cervix?
- You may have mild abdominal cramping, but this is unlikely.
- You may use ibuprofen or panadeine before your appointment to prevent this discomfort.
- You can generally leave our Glengarry rooms straight afterwards, and driving is fine.
- You may have a small amount of bleeding or dark coloured discharge. This may last a few days. The nurse will give you a sanitary pad.
- You can bathe, shower, and resume your usual activities straight away but….
- …you should avoid intercourse until any discharge settles.
If you have any problems, call the PEARL office or seek other medical help out of hours.
Will I need further treatment?
You may or may not need treatment based on your colposcopy and test results. Dr Sillender will recommend the right treatment for you. Definitive treatments are often arranged within 1-3 weeks of your colposcopy, at Glengarry Private Hospital after we’ve seen your results.
Commonly used management plans include: observation with more regular PAP smears; having another colposcopy; or removing all the abnormal cells with a LLETZ. Most treatments can be done awake, but general anaesthesia is available.
If you have a polyp on the cervix this may be removed on this first visit, with your consent.
Your colposcopy test results
Dr Sillender may discuss the colposcopy findings with you immediately after the test. In other cases a follow-up visit here at Glengarry, Perth may be arranged to discuss your test results and possible treatment. A follow-up appointment may or may not be needed, it depends upon results. Let us know if you’re happy to have your results emailed. If recommended, it is important to keep all follow-up visits.
Dr Sillender will send a letter to your GP or sexual health specialist about your findings and follow-up care. If you have any questions or concerns, please call us at our rooms opposite Glengarry Private Hospital, Perth for more information.
Can I come for colposcopy if I am menstruating?
Yes, if your flow is not too heavy and you are comfortable being examined. However, for your comfort, you may wish to rebook your appointment. Please call us to rebook if needed.
Should I have a colposcopy examination if I am pregnant?
If you are pregnant, keep your colposcopy appointment. Observation is usually all that is needed, even with high grade change. Any necessary treatments are usually done 6 weeks after the birth. Colposcopy in pregnancy is perfectly safe.
Can I see the changes on my cervix?
Our colposcope here at Glengarry is equipped with a video camera and TV monitor. You can see on this monitor what we are seeing through the colposcope. This may give you a better understanding of what is happening. However, many of our patients choose not to watch the monitor!
Who will be in the room?
There will be a nurse in the room to assist Dr Sillender with the colposcopy. If you wish, you may bring someone in with you, who will sit next to your top end.