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Colposcopy

Why will I need a colposcopy?

Colposcopy is an examination to examine abnormal cells on the uterine cervix. In most cases, the indication for a colposcopy is an abnormal smear test result. Typically, a colposcopy is not performed to diagnose cervical cancer.

In Australia, every year, 2,000,000 Australian women have a cervical cancer screening test. Of those, some 100,000 women will return an abnormal test result and of those, 15,000 women will require treatment for precancerous abnormalities.

Only a small proportion (700 of the 100,000 women) will be diagnosed with cervical cancer.

How is a colposcopy performed?

This examination is performed in the clinic. You do not need to prepare for it. A colposcopy is still safe when you are pregnant.

A colposcopy takes approximately 10 to 20 minutes.

You will need to undress from the waistline down and lie on an examination couch with the legs up. I will gently insert a speculum into the vagina (similar to when you had a smear test). Then I will bring a microscope in that will remain approximately 20 cm to 30 cm away from the vagina. It allows me to see the cervix under magnification.

I will then apply one or two types of liquid onto your cervix. One of the liquids is acetic acid (vinegar) and the other is Lugol’s solution (containing iodine). Both liquids will stain the cervix and highlight any abnormal cells.

Typically, a small biopsy is taken from one of these areas that look abnormal.

How long will the results take to become available?

The specialist performing the colposcopy should be able to share his impression with you. If a biopsy was taken during the colposcopy, it will be submitted for pathology testing and examined under the microscope. This may take a week and your doctor may ask you to return to the clinic to discuss the findings.

What are the risks of a colposcopy?

  • The application of the liquids may cause a stinging sensation. The liquids may also smell.
  • The biopsy may be uncomfortable but should not cause heavy pain.
  • After the biopsy, the doctor will apply a paste to the local area to stop the bleeding. This paste may cause a mildly burning sensation.
  • After the examination, you can leave the practice and return to your normal daily activities. Typically, no painkillers are required; you can drive. For a couple of days, a brownish discharge is possible. Please wait to have intercourse until after the discharge settles.
  • If you bleed significantly, please let your doctor know.

What are the possible implications?

Pending the outcomes of the colposcopy and the biopsy, the possible outcomes are:

  1. Doing nothing for now and repeat the test after a few months. Sometimes that is the best solution for changes that are mild and likely disappear by itself.
  2. A LLETZ or cone biopsy. This is a day-surgical procedure to excise a cone-shaped portion of the lower pole of the uterine cervix. This procedure is indicated for women who have precancerous changes on the cervix.
  3. If your specialist is concerned about the possibility of cervical cancer, you will be offered a referral to a gynaecological oncologist (such as Prof. Obermair) who will take over your care.

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Pictured: Colposcopy allows the specialist to visualise abnormal cells on the cervix (here stained white and bright yellow) that could not be visualised without colposcopy.

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