While you may have an abnormal pap smear or HPV test result, it does not mean that you have cancer. A pap smear or HPV test is a test to screen for cells on the cervix that may have the potential to become cancerous in future. These are called pre-cancerous cells. A pap smear is able to pick up cancerous or non-cancerous related changes. Early detection of these changes is important because they can be effectively treated with early detection.
The most common way to identify if you have pre-cancerous changes on your cervix is by doing a procedure called colposcopy.
What is Colposcopy?
A colposcopy is a simple outpatient procedure to allow your gynae to see the abnormal cells on your cervix. It helps the gynae identify the most suitable treatment for you.
A colposcopy is done using a colposcope which functions like a magnifying glass. It helps the doctor to examine the changes on your cervix in greater detail.
Preparing for Your Colposcopy Appointment
Doing a colposcopy can be very stressful for some women. You can bring your partner or a friend for support if you wish.
It is recommended to do a colposcopy when you are not menstruating. The entire procedure usually takes 15 minutes. However, please allow at least one hour for the consultation session with the doctor before the procedure.
What Happens During a Colposcopy?
You will be seen by the specialists who will ask you some relevant questions. After the consultation, a nurse will bring you to the changing room where you will sit on a special couch. When you are comfortably positioned on the couch, a speculum is gently inserted into your vagina (similar to a Pap smear examination) so that the vaginal walls are held apart to allow the specialists to see your cervix clearly. In order to identify abnormal cells on the cervix, the doctor will gently use different liquids on your cervix which will highlight the abnormal cells.
If an abnormal area is identified, the doctor may take a small sample of tissue. This is called a cervical punch biopsy. This biopsy is the size of a pinhead. You may feel a slight stinging sensation when the biopsy is taken but it should not be painful. The biopsy will be sent for analysis in the laboratory to check for any abnormal cells that will require treatment.
You will be given an appointment in 1-2 weeks’ time to return to the clinic to discuss the result.
What are the Treatments Available If There are Pre-cancerous Cells Present?
There are several ways to treat pre-cancerous cells on the cervix. Not every woman will require the same treatment. The doctor will identify the most suitable treatment and discuss this with you.
1. LEEP (Loop Excision Electrical Procedure)
LEEP is performed using a fine-heated wire loop. An electrical current is passed through the wire loop and this is then used to cut away the abnormal area on the cervix.
2. Cone Biopsy
A cone biopsy is a minor operation where a small piece of the cervix, in a shape of a small cone containing abnormal cells, is removed from the cervix using either a laser, a surgical knife or by electrosurgery.
3. Laser Vaporisation
This procedure involves using a laser beam to destroy the area where the abnormal cells are on the cervix.
4. Cold Coagulation
Cold coagulation is a simple procedure which is usually performed in a colposcopy clinic. The area with the abnormal cells on your cervix is heated away using a hot coagulation probe. The procedure takes about 45 to 60 seconds and is very well tolerated by the majority of women.
All these treatments are well tolerated by women. Some of these procedures can be done under local anaesthetic while you are awake or under general anaesthetic.
Which Treatment is Suitable For Me?
Your colposcopist will be able to advise you on the best treatment for you to ensure the complete removal of the abnormal cells.
What Happens After a Colposcopy?
There is usually very little discomfort after the procedure.
A brown-coloured paste called Monsell’s solution may be placed on your cervix. It acts like a liquid plaster to help stop any bleeding. You can also expect some spotting or brownish discharge for a few days.
If a cervical biopsy was taken during colposcopy, it is usually advisable to avoid sexual intercourse or the use of tampons for 2 weeks to allow for the healing process.
Sometimes, you may also feel mild abdominal pain that feels like period cramps, after treatment. These cramps usually go away after taking some mild painkillers like Paracetamol.
Your subsequent period may be a little heavier than usual but this is normal. However, if the bleeding is very heavy, please contact your doctor or the clinic.
Will I Need Further Check-ups After Treatment?
Follow-up appointments are necessary after treatment to ensure that all abnormal areas have been treated and the cervix has healed well.
Your doctor will advise you on the result of your treatment and plan for a follow-up to ensure that the abnormal cells do not come back.
What If I Am Pregnant?
A colposcopy procedure is safe in pregnancy. However, treatment is usually carried out after you have delivered your baby. Your colposcopist will be able to advise you more regarding this.
Colposcopy will not induce early labour. It also does not affect your fertility.
