As you may know, the cervical screening test (a smear) is designed to identify early changes in some of the cells at the neck of the womb (this part of your body can also be called the cervix).
If these cells are left unattended, they could cause problems at a later stage in your life. Your recent cervical screening test has shown some of these cell changes, which act as an early warning sign that, over time, cervical cancer may develop. So, you are here because a colposcopy examination is the next step in the cervical screening programme.
This is caused by a virus called the Human Papilloma Virus (HPV), which you could have picked up years ago. It is very common and at least 8 out of 10 women have the virus at some time. Fortunately most women’s bodies reject the virus, but some do not. Smokers are less able to reject the virus. If the virus stays in the cervix for 10 - 12 years, it can irritate the cells and drive them to a change which can then lead onto cervical cancer but only in a very few women.
We would not normally perform a colposcopy while a woman is bleeding heavily because the view of the cervix is not ideal then. However, some colposcopists will undertake the examination if the loss is light.
You will be asked to fill in a questionnaire about yourself and to sign a consent form about the examination and colposcopy procedures. The colposcopist will then see you and answer any questions. You will have your colposcopy examination, when your colposcopist will see where the problem is and decide what needs to be done.
There are 4 possible things that might happen during your colposcopy appointment:
1. Your colposcopist might see no problem. If this happens, you will be advised to have a cervical screening test repeated. This can be anytime between 6 months and 3 years depending on your particular problem.
2. Your colposcopist might see some very minor changes and will take some biopsies. These are tiny pinches of skin, which do not even need local anaesthetic. They have no harmful effects, but you must avoid sexual intercourse, using tampons, soaking for a long time in the bath and excessive exercise for 2 - 4 days.
After this procedure, you can sometimes have a moderate or heavy vaginal loss for up to 6 days. 1 in 20 women may also experience some pain which lasts on average for 2 days. (The TOMBOLA Group 2009). Once the report comes through, your colposcopist will write to you and your doctor with the results and advice on what to do next.
3. Your colposcopist might see some abnormal tissue and advise you that you should have this treated. The treatment is called Large Loop Excision of the Transformation Zone (LLETZ). This can be done straightaway or on another day – it is up to you.
4. Your colposcopist might see some abnormal tissue and advise you that this should be treated. You may be advised to have this performed under a general anaesthetic. This does not mean the problem is more serious. The area may be difficult to get at or is deeper into the cervix requiring a bigger biopsy called a cone biopsy. If you do need this treatment we aim to get you in as a day case patient within 4 weeks of your colposcopy appointment.