A colposcopy is a quick, simple medical procedure to examine your cervix. This is the lower part of the womb at the top of the vagina. You may feel nervous about the procedure, but it helps to know what you can expect. Mr Ashfaq Khan, Gynaecologist at Highgate Hospital, answers your frequently asked questions about having a colposcopy.
What is a colposcopy and why might I need to have this procedure?
The NHS invites all women and people with a cervix aged between 25 and 64 for cervical screening. A sample of cells is taken from your cervix and tested for certain types of the human papillomavirus (HPV). HPV are a common group of viruses. They do not cause any problems in most people, but some types can cause genital warts or abnormal changes in the cells. These changes can sometimes turn into cervical cancer over time if not treated.
A colposcopy is a follow-up to the cervical screening test. It is performed if you did not get a normal or conclusive screening result, or your cervix did not look as healthy as it should. During a colposcopy, your consultant uses a magnified camera with a light called a colposcope to look at your cervix in more detail. If there are any abnormal areas on the cervix, your consultant may take a small tissue sample called a biopsy for further testing.
If you have unusual vaginal bleeding or lower genital itching and soreness, you may also need to be examined with a colposcope. The procedure can check whether you have:
- abnormal cells in the cervix, vagina or vulva (the outer part of the female genitals)
- inflammation or infection of the cervix
- genital warts, which may be a sign of an HPV infection
- non-cancerous growths called polyps or cysts
How can I prepare for my colposcopy appointment?
A colposcopy is a simple procedure, which may cause mild discomfort when a device called a speculum is inserted in your vagina. You do not usually need to take any painkillers before or after the procedure.
You can eat and drink as usual before your colposcopy appointment. It is best to avoid having sex and using tampons or vaginal medicines for at least 24 hours in advance. You may find it helpful to bring a panty liner to your appointment in case you have any discharge or light bleeding afterwards.
If you have your menstrual period on the day of the procedure, your appointment can normally still go ahead. In some cases where your bleeding is heavy, you may need to reschedule the appointment.
It is important to tell your consultant if you take any medicines that thin the blood or may be pregnant. It is safe to have a colposcopy during pregnancy, but a biopsy and any treatment will probably be delayed.
What happens during the colposcopy procedure and is it painful?
A colposcopy is a quick procedure, which only takes about five to seven minutes to complete. You have the procedure in our Outpatient Department and can go home on the same day. At Highgate Hospital, we offer a one-stop service with minimal waiting time for an appointment.
When you arrive for the appointment, your consultant answers any questions that you may have. We ask you to undress from the waist down in a private area and lie on a couch with your knees apart. You can rest your legs on padded supports.
Your consultant gently puts a small device called a speculum into the vagina. This holds the vagina open, so that your consultant can see the cervix. It is similar to having a cervical screening test. The consultant uses soft cotton to soak the cervix with a special liquid that contains 5% acetic acid (a weak acidic liquid). This liquid highlights any abnormal areas on the cervix.
Next, your consultant uses the microscope with a light called a colposcope to look closely at your cervix. The colposcope does not go inside or touch your body. If there are unusual areas on the cervix, you may have immediate treatment to remove abnormal cells. Otherwise, your consultant may take a sample of the cells called a biopsy. This sample is sent to a laboratory to be checked under a more powerful microscope
If you have a biopsy, we give you a medicine called a local anaesthetic to make the area numb. The procedure is then pain-free and you do not need any painkillers afterwards.
When will I get the results of the colposcopy and what might they mean?
Your consultant may be able to tell you the results of the colposcopy during the same appointment. If you had a biopsy, the sample of cells from your cervix needs to be tested in a laboratory. At Highgate Hospital, we try to minimise the anxiety of waiting for test results. Within one week, you get a report setting out your results and your consultant makes a personal management plan for you.
You either have:
- A normal result: About 4 in 10 people get a normal test result. This means that your cervix looks healthy. You just need to continue attending cervical screening appointments.
- Abnormal cells confirmed: About 6 in 10 people have abnormal cells in their cervix. In some cases, these cells can be left alone for now. They may disappear on their own when your body gets rid of the HPV. In other cases, you may need treatment to remove the abnormal cells and reduce the risk of cervical cancer.
Rarely, cervical cancer may be diagnosed during a colposcopy and biopsy. We then refer you promptly for specialist care and treatment.
If I have an abnormal colposcopy result, what treatment can you offer me?
If a colposcopy shows abnormal cells in your cervix, you may need treatment to remove them. Treatment is usually recommended if there is a moderate or high risk of the cells becoming cancerous.
There are various treatments available, which aim to remove the abnormal cells without damaging healthy parts of the cervix. They include:
- Loop treatment: LLETZ (large loop excision of the transformation zone) is the most common treatment to remove abnormal cells. The transformation zone is the area around the opening of the cervix, where cells are most likely to become cancerous. This procedure is also sometimes called LEEP (loop electrosurgical excision procedure). Your consultant uses a thin wire loop that is heated with an electric current to remove the area of abnormal cells. The procedure only takes about 10 minutes and can be done at the same time as a colposcopy. You usually have a local anaesthetic to make the area numb and can go home afterwards.
- NETZ procedure: The NETZ (needle excision of the transformation zone) procedure is similar to LLETZ. However, your consultant uses a straight wire rather than a loop-shaped wire to remove the area of abnormal cells. You may have the NETZ procedure if the abnormal cells are in the narrow passage through the cervix called the cervical canal.
- Cone biopsy: This is a minor operation to remove a cone-shaped area of the cervix containing abnormal cells. It is less common than the LLETZ procedure and generally used to remove a larger area of tissue from the cervix. A cone biopsy cannot be done at the same time as a colposcopy. You usually have a general anaesthetic, which sends you to sleep during the procedure, and may stay in hospital overnight.
- Other treatments: Abnormal cells in the cervix can also be destroyed with heat treatment (cold coagulation), freezing treatment (cryotherapy) or laser treatment.
Your consultant makes an individual treatment plan that suits you.
About Mr Ashfaq Khan, Consultant Gynaecologist
Mr Ashfaq Khan is an internationally renowned and experienced colposcopist (a specialist in performing colposcopy procedures). He led the colposcopy and vulva disease service at Whittington Health NHS Trust for six years.
To make an appointment with Mr Khan at Highgate Hospital, please call 020 3918 9522 or complete this form.