A colposcopy is a procedure done to closely examine your cervix, vagina and vulva for signs of disease. This is often indicated for suspected pre cancer cells detected on pap smear or biopsy of tissue.
During colposcopy, your doctor uses a special instrument called a colposcope which magnifies the tissues allowing the doctor to view the cells of the cervix(opening of the womb), the vaginal tissue and the labia(lips of the vagina). If abnormal cells are found, they can be treated or removed using a large loop excision of the transformation zone (LLETZ) or the less commonly used cold knife cone biopsy. The LLETZ procedure entails the use of an electrical current which is passed through a wire loop which is then used to burn off any abnormal pre-cancer cells. In the event of a suspected cancer a biopsy or sample of the tissue is taken. In the event of suspected vaginal or vulva lesions the lesion is cut out with a knife and a few stitches may be placed.
Colposcopy procedure
This procedure is usually done under a light general anaesthetic at the day hospital. During a colposcopy, Dr Guzha will open the vagina using a speculum to allow the colposcope into the cervix. The colposcope which is fitted with a camera and a light will provide Dr Guzha with images of the internal lining of the cervix on a monitor. If any abnormal areas are identified, a small sample of tissue (a biopsy) may be removed and sent for testing in a laboratory. In cases where Dr Guzha is able to diagnose the issue, she may proceed with treatment immediately.
Treatments done in addition to a colposcopy
The most common treatment is a large loop excision of the transformation zone (LLETZ). An LLETZ is also known as a loop diathermy, loop cone, loop biopsy or loop excision. This procedure can be done with local anaesthesia and involves a heated wire loop which is used to remove abnormal cells at the entrance of the birth canal.
Less commonly, a cone biopsy may be done. This is usually done for larger tissues that require removal. During a cone biopsy, a cone-shaped piece of tissue containing the abnormal cells is removed. This is done under general anaesthesia and may require an overnight stay in hospital.
Laser treatment and cold coagulation may also be done as treatment for minor abnormal cells or cell changes.
There is a small risk for serious complications such as:
- Infection of the wound
- Fever
- Bladder infection – which may gradually resolve
- Bleeding – resulting in the need for blood transfusion
You will be able to go home and rest immediately after a colposcopy. If a biopsy was sent for testing, you will receive feedback on the results within a few weeks of your procedure. If treatment was done at the same time, you can expect mild pain, similar to period pain, but this should pass within a few hours. Pain medication will also be prescribed for this. Light vaginal bleeding or brown vaginal discharge after a colposcopy is also common. Discharge may last up to 4 weeks. You will be advised to refrain from inserting anything into your vagina for 4 weeks and to refrain from sexual intercoarse. Dr Guzha may need to perform a follow-up screening or surgery depending on the results, but this will be discussed with you during your procedure.