Colposcopy is a test used for the diagnosis of abnormalities of the cervix, vagina and vulva. It is performed using the colposcope, a light source with integrated magnifying glass system, to examine the lower genital tract system after the application of special solutions which make any possible lesions visible. During the examination, the colposcopist can assess the severity of the lesions, map them, and decide / advise on appropriate management (simple monitoring, biopsy and / or treatment). If a biopsy is needed, it can (in the vast majority of cases) be performed in the outpatient setting as part of the examination.
What you would feel if you underwent colposcopy is very similar to having your smear as the introduction of a vaginal speculum is necessary. The difference is that the process takes slightly longer (5-10 minutes in most cases). Some women may feel a burning sensation with the application of the solutions (diluted acetic acid solution and iodine lugol), however not necessarily. If a biopsy is indicated, the procedure is very quick to perform. What you may feel is mild period cramps. Should a biopsy be taken, you will need to avoid sexual intercourse and bathing for 2-5 days, until the brown vaginal discharge you will be experiencing settles.
Indications for colposcopy
- An abnormal smear result and / or persistent HPV infection
- Abnormal appearances of the cervix or vagina during gynaecological examination
- Abnormal symptoms such as post-coital bleeding and/or persistent, abnormal/blood-stained vaginal discharge
- Follow-up for women with history of treatment for cervical and/or vaginal lesions
Most cervical abnormalities are managed conservatively, by repeating their smear test and colposcopy after 6-12 months, as the are likely to regress within 1-2 years from diagnosis. When treatment is indicated, this (in most cases) involves the removal of the abnormal tissue (loop excision, LLETZ, LEEP, conisation) and can be performed under either local or general anaesthetic as day case procedure. Treatments are very safe and if performed appropriately they carry a very low risk ratio. Their likelihood of being successful and turning your smears back to normal is at least 95%. If you need a treatment, indications, risks, and future follow up will be discussed with you in detail.
It is best to have a colposcopy outside of your period. However, as long as you are not bleeding heavily, it can be successfully performed at any time during your menstrual cycle. Prior to the test you should avoid sexual intercourse, the use of vaginal suppositories / creams and vaginal washes for 24-48 hours.
You will also need to provide test results (Pap smears, vaginal swabs, any previous colposcopies and biopsy results) and information about your medical history including medication if you are taking any.