Colposcopy – Glengarry Private Hospital, Perth
Colposcopy – Summary
Discomfort is similar to a smear test
1. A specialist examination used to check for abnormalities of the cells of the cervix.
2. The commonest reason for colposcopy is after an abnormal smear result.
3. Colposcopy is commonly performed in Perth and Australia.
4. The colposcopy takes about 5-10 minutes. A little more time is needed if a biopsy is taken.
5. Colposcopy by itself is no more uncomfortable than having a smear. It just takes longer.
6. A small biopsy is quite often needed – some women find this uncomfortable.
7. Areas that are found to have severely abnormal pre-cancerous change need to be removed in the hospital.
8. Smears & colposcopy overall reduces the chance of getting cancer of the cervix.
Make an appointment
Glengarry Private Hospital is a friendly medium-sized hospital in the Northern suburbs in Duncraig, very near to the freeway, midway between Joondalup and Osborne Park Hospital. Our comfortable rooms are just opposite.
Call us to arrange a consultation • Perth (08) 6119 9160
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 smear test. Abnormal smear tests are now more common as there is a new improved test (the “CST” or Cervical Screening Test) which picks up more abnormalities. 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 assess whether there are abnormal cells, how bad they are & their extent. These abnormal cells are usually picked up after a smear test has been reported as abnormal. 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 examine the cervix and see abnormal cells in great detail by magnifying the cervix using a special 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 cell change.
Following this, the cervix is painted with one, or sometimes two, types of fluid (acetic acid & aqueous iodine) to highlight the abnormal cells. A judgement is made about how severe the changes to the cells are.
We also judge whether we can see all of the abnormal areas. Sometimes abnormal cells may be up inside the canal of 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 smear (called a cytobrush – this samples cells from deep inside the cervix)
- small biopsy or biopsies (we’ll often do these – they are very straightforward but can be a little uncomfortable)
- larger excisional (or full treatment) biopsies that remove all the abnormal cells – we do these in Glengarry hospital
These larger treatment biopsies are usually done under local anaesthetic in the operating theatre at Glengarry, Perth. General anaesthetics can also be provided (and are sometimes preferred by patients), again at Glengarry Private Hospital. It is your choice which type of anaesthetic you have.
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 smear test result.
- Two mildly abnormal smear results a year apart.
- 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 smear test result mean?
When the scientists who examine smears looked at your smear in the lab, they detected either “high risk” or “other” HPV, and possibly cells that looked different from the normal cells. An abnormal smear test result may indicate the presence of:
- HPV (Human Papillomavirus). Detecting this extremely common virus is now the first part of the smear. If you have the riskiest type of HPV, colposcopy is needed. If you have the less risky type, you can repeat the smear in a year.
- Low grade abnormal change. This is due to changes caused by HPV or other causes, causing a reaction by the cells on the cervix. Usually it will settle with time, but if it persists high grade change does need to be ruled out with colposcopy.
- High grade abnormal cell change. High grade change is where there may be a significant pre-cancerous change. In other words, if it were left, it might develop into cancer of the cervix. This change 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 some abnormal cell changes that are due to infection.
- Aging. Thin skin seen in older women can get infected causing changes that mimic pre-cancerous changes.
- “Normal” inflammation or cervicitis. This is very common. Often this mild irritation settles down by itself with no treatment.
Does an abnormal smear mean I have cancer of the cervix?
An abnormal 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 smear test is used to detect medium or high risk HPV or abnormal cell changes, allowing assessment with removal of any abnormal cells before cancer develops.
How is a colposcopy done?
It is very similar to the smear test. We have a dedicated room in our offices at Glengarry in Perth, with an electronic 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 smear test.
We then examine the cervix with the colposcope. Another targeted smear (a cytobrush) may be taken. A solution is applied to the cervix and vagina. Any abnormal areas are examined with the colposcope & a biopsy may be taken. The colposcope does not enter your body. The examination usually takes about 10 minutes. Biopsies (if needed) may take a little longer, as they may bleed a little and we need to stop this before you go home.
Will a biopsy (a small tissue sample) be done at the colposcopy?
If any abnormal areas are seen, a biopsy or small tissue sample can be taken during the colposcopy. You may feel a pinch when the biopsy is taken (but we will distract you). Many do not feel any discomfort at all. Silver solution is applied to the biopsy site afterwards to help stop any bleeding. Afterwards, wear a pad & avoid intercourse, baths or tampons until any bleeding or discharge stops.
What happens after a biopsy of the cervix?
- You may have mild abdominal cramping.
- You may use ibuprofen or panadeine before your appointment to help prevent this discomfort.
- You can generally leave our Glengarry rooms soon afterwards, and driving is fine once you’ve settled.
- You may have a small amount of bleeding or dark or silver coloured discharge. This may last a few days. Michelle or Elaine will give you a sanitary pad.
- You can shower, and resume most of your usual activities straight away but….
- …you should avoid intercourse, swimming, bathing and vigorous exercise 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 smears; having another colposcopy; or removing all the abnormal cells with a LLETZ. Most treatments can be done awake under local anaesthesia, 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 – bear in mind email is not secure. If follow up is recommended, it is very 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 after the birth. Colposcopy in pregnancy is perfectly safe, and we will not do a biopsy.
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 at the head-end of the couch.