Colposcopy

A colposcopy is a simple procedure used to look at and assess the cervix. It's often done if cervical screening (smear test) finds abnormal cells on your cervix, or your GP refers you with simple issues such as polyps (small growths) or bleeding after intercourse.   

These cells often go away on their own, but sometimes there's a risk they could eventually turn into cervical cancer if not treated.  

A colposcopy can confirm whether cells in your cervix are abnormal and can determine whether you need treatment to remove them.  

Our dedicated colposcopy service is run by consultants and clinical nurse specialists across Heartlands, Good Hope and Solihull Hospitals.   

If your cervical screening (smear test) is reported as abnormal then a direct referral will be made to the colposcopy department, and you will be seen one of our specially trained colposcopy nurses and doctors. They can then assess your cervix and diagnose any problems. This may involve taking a biopsy of your cervix to determine which treatment, if any, may be required. Treatments performed include cold coagulation (ablative treatment) or LLETZ (Large loop excision of the transformation zone- excisional treatment). We may also need to see you again after treatment for follow up cervical screening.  This may be done in the colposcopy department or at your GP clinic.   

We also treat minor issues following a GP referral such as polyps and bleeding after intercourse.   

Why have I been invited to attend a colposcopy treatment appointment?

If you have received a letter to invite you to a colposcopy treatment appointment following a biopsy you had taken from your cervix, you may be asked to attend a follow-up appointment for one or more of the following reasons: 

• We need to re-assess you and potentially take another biopsy to ensure that we are providing you with the safest possible care 

• You have been complaining of ‘bleeding after sex (PCB- postcoital bleeding)’ and you indicated during your appointment that you would like a treatment to help resolve these symptoms 

• You will be offered a treatment for abnormal cells; either cold-coagulation or a LLETZ. The treatment option you are offered will depend on your age, where the abnormalities were found, and whether you have had treatment previously. The colposcopist will advise on which treatment is safest for you. If you would prefer a treatment under a general anaesthetic, please let the colposcopist know.  

Please be aware that you will be asked to provide a urine sample when you come to your appointment.  

It is recommended that you take simple pain relief (such as paracetamol) before coming to your appointment, in case you experience some mild cramps (like period pain) afterwards. 

Treatments

Cold coagulation

You may be advised to have this treatment if:  

• you are experiencing bleeding after sex and have had no previous cervical treatment 

• you have not had a treatment to your cervix in the past 

• you are under the age of 40 years old 

• your biopsy indicates that your abnormal cells are on the outside of your cervix and do not track up into your womb  

• there is only a small area where abnormal cells have been found  

Once a urine sample has been provided and test confirms that you are not pregnant, we will be able to go ahead with the procedure.  During the procedure, we will give you a local anaesthetic to numb your cervix so that you do not feel any pain from the procedure.  Then a speculum will be placed inside you (it will be a bit stretchier than the last speculum you had) and once you are numb, we will apply a hot probe onto your cervix for roughly 60 seconds to burn the cells away.  

Following this procedure, it is important that you follow our aftercare advice (you will be given an advice leaflet). The risk of infection is extremely low if you follow the advice and guidance following the procedure. You will have a watery discharge for up to six weeks that has a slight smell.  We advise that you do not have sex, use tampons, over-wash yourself or use swimming pools/hot tubs for six weeks.  

You can carry on as normal after the recovery period.  

Large-loop excision of the cervix (LLETZ) 

You will be offered this treatment if:

• you have previously had a treatment to your cervix (i.e. previous cold-coagulation, laser therapy, cryotherapy or LLETZ), even if it was many years ago 

• if you are over the age of 40 years old 

• if the abnormal cells found cover a large surface area on your cervix 

• if your biopsy results indicate that some of the abnormal cells are tracking up from the cervix towards your womb 

• if you have a coil (hormone/mirena or copper coil) this will need to be removed before the procedure - you will be able to ask your GP to reinsert it when you are fully healed after around two months post-procedure  

As for the cold coagulation procedure, you will receive a local anaesthetic, and once your cervix is numb, a speculum will be placed inside your cervix.  We will use a small wire to remove a small area from your cervix (roughly one cm in size) and send it off to be tested to check if all your abnormal cells are within the sample. Usually, one treatment is enough to remove all of the cells, however you may need to return for another treatment if the laboratory feel some abnormal cells are still present in your cervix after the first treatment. We will use equipment to stop you from bleeding after the procedure and apply a brown paste; the same paste that was used for the original biopsy you had taken.  

If you want to stop at any point during the procedure, please do not be afraid to inform the colposcopist.

Following this procedure, it is important that you follow our aftercare advice (you will be given an advice leaflet) to minimise the chance of infection.  

You will have a brown/black discharge for up to six weeks that has a slight smell.  We advise that you do not have sex, use tampons, over-wash yourself or use swimming pools/hot tubs for six weeks. You may also pass what looks like a clot roughly one week after your procedure.  This is normal and is the scab from the procedure coming away.  

You may notice some bleeding following the procedure.  Providing it is not a heavy bleed, this is normal. You can call our office for advice if you are unsure.  

You can continue with you normal daily routine once you have recovered from the procedure.  

If you were given a treatment because of abnormal cells, you will have a smear test six months after the treatment (usually at your GP survery) to check if all the abnormal cells have been successfully removed. If any are remaining, you will be referred back to the colposcopy department so we can assess you.  

What should I expect when I arrive for my appointment? 

When you arrive in the colposcopy department you will need to check in at the reception where the receptionist will confirm some details such as your name, address and date of birth.  

You may be required to produce a urine sample, so please check with the reception staff before you go to the toilet. 

A member of nursing staff will then call you into the clinic room where all staff who are present will be introduced.  This could be a trained nurse, Healthcare Assistant and a colposcopist. Occasionally there may be student doctors or nurses observing the appointment, but you will be asked if you are happy for them to stay in the room. 

There will an opportunity to go through your medical history, and what will happen during the colposcopy procedure will be explained before the procedure takes place.