Miss Ghadah Ahson, Consultant Gynaecologist, offers colposcopy assessments here at One Hatfield Hospital on Wednesday evenings and Friday mornings. A colposcopy can be for diagnostics only or for immediate assessment and treatment.
We asked Miss Ahson to tell us more about the procedure, why it would be needed, and what patients can expect.
What is a colposcopy?
A colposcopy is a simple procedure that allows detailed examination of the cervix (neck of the womb), vagina and vulva with a microscope. It allows the detection and treatment of pre-cancerous cell changes, as well as very early stages of cervical cancer.
Why have a colposcopy?
The most common indication for a colposcopy is an abnormal cervical screening test result (smear test) that has shown evidence of abnormal cervical cells or high-risk HPVs (human papilloma viruses).
Some women may require a colposcopy despite negative cervical screening test results. For example their GP has referred them because of persistent post-coital bleeding, uncertainty about the appearance of the cervix, vulva or vagina. In some cases it may be because a satisfactory cell sample cannot be obtained with a smear test.
What happens during a colposcopy ?
I conduct an initial consultation for all new patients before their colposcopy assessment, usually at the same appointment, so that they have a clear understanding of what to expect. Following their assessment I will make recommendations on management. Either nothing further, or biopsy or treatment is needed. Patients are advised before they leave if a follow up is required or results are awaited.
What is a biopsy?
A small sample of tissue is removed for closer examination in a laboratory. This shouldn’t be painful, but you may feel a slight pinch or stinging sensation
What treatments might be advised?
The main treatment performed is called a Large Loop Excision of the Transformation Zone (LLETZ). This treatment is very quick, and is performed under local anaesthetic. This is either performed at the first visit or after an initial biopsy. A very small proportion of women may need to have this under general anaesthetic as a day case procedure.
Other treatments can be performed for other problems affecting the cervix such as cautery, which is again performed under local anaesthetic.
If abnormal cells are found, can they be treated at the time of the colposcopy?
Absolutely. If abnormal cell changes are detected during the colposcopy, they can be treated immediately if indicated. I can do it there and then or, if they need time, they can ask to have it done at another appointment.
Can patients self-refer?
Anyone can choose to have a colposcopy at One Hatfield Hospital, but patients must clearly indicate that they require a colposcopy so that appropriate slot is booked and supporting clinical staff are aware to prepare accordingly. Patients must also bring with them their abnormal cervical smear test result or, if they are attending for any other reason, a referral letter from their GP.
What if I am pregnant?
A colposcopy can be done safely during pregnancy and will not affect delivery of the baby, nor will it affect the ability to become pregnant in the future. However, treatment is usually postponed until after the delivery of the baby. Very occasionally biopsies may need to be taken during pregnancy. Please inform the booking team if you are pregnant.
If the need for treatment is anticipated, it is advisable to take simple pain killers, such as Paracetamol or Ibuprofen, one hour prior to the procedure to help with the mild discomfort that they may feel. Although it is usually not necessary.
If it is anticipated that your period might arrive around the time of your colposcopy appointment please call us for advice.