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 ColposcopyHillingdon Hospital: Main building, Elizabeth Outpatients (3rd floor) Colposcopy is a diagnostic tool to determine the cause of abnormalities found in Pap smears. A Colposcopy is a visual examination of the cervix and is relatively simple and painless procedure. Please inform Elizabeth Outpatients on 01895 279670 well in advance if you cannot attend for any reason. We are committed to the comfort and wellbeing of patients. When you come for your appointment there will always be a Staff Grade nurse and an HCA nurse to chaperone you.
What is colposcopy?Colposcopy is a simple examination that allows the doctor to see the type and area of the abnormality on your cervix. It also lets the doctor / nurse colposcopist decide if you need treatment. The instrument used is called a colposcope and is really just a large magnifying glass which lets the doctor/ nurse colposcopist look more closely at the changes on your cervix. It does not go inside you. For most women this is a painless examination , but some may fine it a bit uncomfortable. Why do I need a further examination?You have been asked to come for a further appointment because your cervical smear test has shown evidence of abnormal cells. This is not unusual : about one in twelve smears is abnormal. An abnormal result from your cervical smear tests usually means that small changes have been found in the cells on the cervix (the neck of the womb). These abnormal changes are known as dyskaryosis and act as early warning signals that cervical cancer might develop in the future. It is impotant to remember that it is very rare indeed for these abnormalities to be cancer. For some women the changes in the cervix return to normal by themselves. Other women will need some simple out-patient treatment that is virtually 100% effective. Before the examination
Some doctor / nurse colposcopist’s prefer not to do a colposcopy examination when you have your period. If your period is due on your appointment day, please telephone the department to let us know as we may need to offer an alternative appointment. You may wish to wear a full skirt to avoid removing all your lower clothing during the examination. Some women have a slight discharge after the examination. You may want to bring a sanitary towel, just in case. The actual examination only takes about fifteen minutes, but allow at least one hour for the whole visit. The examination procedureFirst the doctor / nurse will want to ask some questions. These questions relate to your period, any operations of illnesses you have had in the past, and so on. You will be asked to undress form the waist downwards (though a full skirt need not be removed). When you are lying comfortably the doctor / nurse colposcopist will insert a speculum into your vagina, just as when you had your smear taken. Sometimes another smear is taken. After this the doctor / nurse colposcopist will look at your cervix using a colposcope (a specially adapted type of microscope with a light source attached). It does not touch you or go inside you. The doctor / nurse colposcopist will then dab different liquids onto your cervix to help identify and highlight any areas of abnormal cells. The abnormal areas will appear white, if any abnormal area is identified, a small sample of tissue is taken from the surface of the cervix. A biopsy is about the size of a pinhead, you may feel a slight stinging, but it should not be painful. What will the examination show?Colposcopy defines the type and extent of the abnormal area on the cervix. The results show if you need treatment and, if so, what sort. The technical term used to refer to changes confirmed by biopsy is cervical intra-epithelial neoplasia, more commonly known as CIN. In order to make distinctions between the various states of change, doctors have developed a scale from 1 to 3 according to how many of the cells are affected. CIN 1: Only a third of the cells in the affected area abnormal. These may be left to return to normal or may be treated, depending on your doctor / nurse colposcopist's opinion. CIN 2: Up to two-thirds of the cells in the affected area are abnormal. Treatment will usually be needed to return the cells to normal. CIN 3: All the cells in the affected area are abnormal. Treatment will be needed to return the cells to normal. Only very rarely will a biopsy show cell changes that have already developed into cancer. Surgery and more extensive treatments are generally used to treat cervical cancer. What if I need treatment?Treatment will be carried out at your first or on your following visit to the colposcopy clinic. You will receive information about the treatment they may give you, please contact us if you have not received this information. There are several equally effective methods available to treat CIN. The aim of the methods of treatment is to destroy all the cells affected by CIN, with the minimum disruption to normal tissue. The choice of treatment will depend on your particular case, on the preference of the doctor / nurse colposcopist doing the colposcopy, and on the methods available at clinic. You can be treated for most abnormalities as an out-patient and so you will not need to stay in hospital. Treatment is nearly always 100% successful and it is unlikely that CIN will recur. What should I do after treatment?If your treatment was given following colposcopy you may have a bloodstained discharge for two to four weeks. During this time, and when you have your period, you will need to use sanitary towels rather than tampons. It is best to avoid heavy exercise swimming and sexual intercourse. These measures allow the cervix to heal as quickly as possible. Treatment for CIN will have little or no effect on your future fertility. There is a risk of less than 5% of a preterm delivery, therefore if you do become pregnant, the neck of your womb will need to be monitored by having subsequent scans. CheckupsIt is important to keep your check-up appointments to make sure your cervix is still healthy. Most Colposcopy clinics have a follow up check between four and six months after the examination or the treatment. During this visit the doctor / nurse colposcopist will take a cervical smear and do another colposcopy examination to make sure that the cervix is healthy again. You may have another follow-up check six months later. This visit will be similar to the previous one Colposcopy during pregnancyIf you are pregnant when you are invited to attend the Colposcopy clinic for a First or Follow up appointment, please inform the Doctor or Nurse Colposcopist at your appointment. It is a safe to have a Colposcopy during your pregnancy, and it does not cause any harm to the baby. You may find that if you have been seen early in your pregnancy, you could also require a further assessment later in your pregnancy. Even if you require treatment, it is usually safe to wait until after the baby is born. Changing and cancelling appointmentsIt is very important that you try and keep your appointment. If you fail to attend without informing us you will be automatically discharged back to your General Practitioner. Further informationIf at anytime you have any questions/queries before you attend, about your visit or your treatment, please do not hesitate to contact our Nurse Colposcopist. This is a teaching hospital. Sometimes student doctors/nurses may be present during your clinic appointment. Although attending these clinics is part of their training, it is your choice if at anytime you do not wish any other person to be present. Whatever your decision, your treatment and the standard of care you receive will not be affected. Patient information leaflets are available in our Out-patient Department. Certain leaflets are available in different languages. Links for further information.
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NHS Cervical Screening Programme: