Information for people referred to the colposcopy clinic

What is colposcopy?

Colposcopy is a means of looking at the neck of the womb (cervix) with a magnifying instrument (colposcope).

This helps the colposcopist, a nurse or a doctor to detect any abnormalities which are present on your cervix.

When you come to the colposcopy clinic for the first time you will be seen by a doctor or nurse who will check your personal details and medical history. Your cervical sample report and what you can expect to happen during your appointment will be explained.

You will be shown to a separate private changing room adjacent to the examination room and asked to remove your lower garments and put on a gown.
You will then enter the examination room.
You will be asked to lie on a couch with your legs supported on rests.

Every effort will be made to ensure your privacy and dignity is maintained throughout the examination e.g. the examination room door will be locked.

A nurse or healthcare assistant will be present throughout the examination,and if you would like your partner or a friend to be present, just mention it to the clinic staff.

The examination

A speculum will be gently inserted into your vagina to allow the colposcopist to see your cervix clearly, some people find this slightly uncomfortable, but it should not be painful.

The colposcope does not go inside you; it is positioned about 30 cm away. The colposcopist uses the colposcope to magnify and direct light onto your cervix to assist with the examination.

A solution of weak acetic acid (mild white vinegar) is then dabbed over your cervix to help identify any abnormal areas.

This should not hurt but some people say they feel a slight stinging sensation. Sometimes a solution of iodine is used. If an abnormal area is identified, a small amount of tissue called a punch biopsy will be removed for examination in the laboratory.

National guidelines exist for the management of abnormalities seen on the cervix.

The clinic procedures follow the recommendations of the NHS Cervical Screening Programme (NHSCSP) and the British Society for Colposcopy and Cervical Pathology (BSCCP).

All of our colposcopists are fully certified by the BSCCP for these procedures.

Why have I been referred to colposcopy clinic?

Your cervical sample (smear) has been reported as inadequate consecutively on several occasions.
Your GP / practice or community nurse had difficulty obtaining a satisfactory cervical sample.
You have experienced bleeding after sex and / or between periods.
Your GP / practice or community nurse is concerned about the appearance of your cervix and would like a second opinion.

Inadequate cervical sample

You have been asked to attend the colposcopy clinic because you have had several consecutive samples that were unsatisfactory / inadequate.

This means that it has not been possible to obtain a reliable result from your test, but it does not necessarily mean that there is anything wrong with your cervix.

Your GP / practice nurse or community nurse have had difficulty obtaining a cervical sample.

Occasionally it is difficult for your GP / Practice Nurseor Community Nurse to see your cervix clearly. In colposcopy we have specialised equipment to enable us to examine you more easily and make the experience more comfortable.

If you are menopausal it is often advisable to use oestrogen cream or pessaries prior to this visit. Oestrogen cream improves the vaginal tissue therefore making the examination more comfortable for you. Oestrogen cream does not become absorbed systemically so is safe to use for short periods.

Please ask your GP to prescribe an oestrogen cream / pessary preparation for you to use prior to your appointment. Please use the cream or pessary for 14 consecutive nights before the appointment and avoid using it 2 nights before the actual appointment.

You have experienced bleeding after sex or between periods.

Your cervix will be examined using the colposcope and swabs may be taken to eliminate infection as a cause of this bleeding.

You will be advised what to do if the tests are positive. The results may be telephoned to you or sent to you by letter and if necessary, instructions will be given concerning treatment. If no cause is found for this bleeding and it persists, you will be discharged back to your GP.

Your GP / nurse is concerned about the appearance of your cervix and would like a second opinion.

Your cervix will be examined using the colposcope. If your cervix appears to be normal (sometimes simple cysts are seen which do not require any intervention) you will be reassured and discharged back to your GP’s care.

If an area of abnormality is seen on your cervix, then a biopsy will be taken.

This will either be a wedge biopsy (a small segment of tissue) or a loop biopsy of tissue which is a larger sample. This will be carried out after local anaesthetic is injected into the cervix.

As the treatment is carried out, you will be aware of the procedure, but you should feel no pain, if you do, tell the nurse who is with you.

The sample will be sent to the laboratory for urgent tests. The colposcopist will give you information regarding the potential abnormality on your cervix but it may not be possible to give a definite diagnosis until the results are back from the laboratory.

You will be given an information leaflet with the name and telephone number of the Nurse Practitioner so you can contact her for advice.

Arrangements will be made to contact you regarding the results.