By Ann Marie Collins, Midwife Colposcopist/CMM2
You’ve had your HPV cervical screening test, and you’ve now got a letter with the result. We’ve invited you to have an examination called a colposcopy because your result showed:
- HPV and abnormal cell changes were found, or
- HPV was found (after two consecutive tests 12 months apart) but no abnormal cells were found.
So what is a colposcopy?
A colposcopy is an examination to take a closer look at your cervix using a small camera. We look for any cell changes, small growths called polyps, or signs of cervical cancer. The aim of cervical screening is to prevent cervical cancer developing by finding and removing cervical abnormalities during colposcopy. For some women who attend colposcopy we find their cervical cancer at an early stage when it’s easier to treat and there’s a better chance of recovery.
A colposcopy is free through the CervicalCheck screening programme.
Where is it done?
It will be done in a colposcopy clinic in a hospital. There are 15 colposcopy clinics in Ireland. The exam is an outpatient procedure – you can go home the same day.
How do I get my appointment?
We’ll send you a letter with your appointment details. If you cannot attend, contact us and we’ll give you a new appointment.
How do I get ready for it?
You do not need to do anything to prepare for a colposcopy.
How long does it take?
The consultation will take 10 to 15 minutes. The exam can take around 5 minutes.
What happens when I arrive at the hospital?
We’ll check you in at the colposcopy clinic - we’ll confirm your name, date of birth, address, next of kin and GP name and address. We’ll show you to a waiting room, and one of our nursing team will call you and bring you to the triage room. Here you will meet your colposcopist. We’ll explain the exam to you, and we’ll ask you for your verbal consent to have the exam. We’re happy to answer your questions.
Who does the exam and what happens?
The exam is done by a trained colposcopist who may be a nurse/midwife or a doctor. There is usually a second person in the room to assist the colposcopist. If you are getting a treatment, there may be two people in the room with the colposcopist – one to support you and one to assist.
We’ll ask you to remove your clothing from the waist down, including your underwear, and we’ll give you a paper gown to put on.
We’ll ask you to sit on a gynaecology bed which is designed to lie your body in the best position for us to look at your cervix. The bed can move up and down as well as tilt you backwards.
We’ll ask for your consent again to insert a speculum into your vagina. This is the same medical instrument used at your cervical screening test. It can feel uncomfortable when inserted and we’ll work with you to help minimise this discomfort. We coat your cervix in a clear solution called acetic acid using a cotton ball. This solution is used to illuminate any abnormalities that may be present in a white colour. We sometimes use another solution called Iodine which is brown in colour and may lead to brown coloured vaginal discharge for a few hours.
If we find abnormal cells, we’ll ask for your consent to take a small sample of tissue (a biopsy). If we find any small growths (polyps) we will usually remove them. We will send these samples to a laboratory to be looked at more closely and tested. We may advise you to have treatment to remove abnormal cells.
The most common treatments are:
- Thermal ablation, also called cold coagulation: a heat source will be applied to the cervix to burn away the abnormal cells. We may need to give you a local anaesthetic for this.
- LLETZ (large loop excision of the transformation zone): we will give you a local anaesthetic for this treatment to help numb your cervix. We’ll advise you to bring someone with you if you need a LLETZ as you will need someone to bring you home.
How we support you during your exam
Colposcopy is an intimate exam. We know that women can be worried or anxious and we’re here to help and reassure you. Some women find a colposcopy uncomfortable, but it should not be painful. You can tell us if you get too uncomfortable or have any concerns during the exam. We can help to make it more comfortable for you such as re-position the speculum or change your position on the bed. We’ll explain what we’re doing during the exam.
What happens after?
We’ll tell you what we saw during the exam and if any samples were taken or polyps removed.
If you did not have a biopsy or any polyps removed, you should be able to resume your normal day-to-day activities immediately afterwards.
If you had a biopsy or had some polyps removed, you may have some bleeding (spotting) for a few hours afterwards. We’ll advise you not to have sex, not to use tampons and not to insert anything into your vagina for 2 to 3 days afterwards.
If you have treatment, you should be able to go home the same day. Most people feel well enough to return to work and carry out normal activities the next day. It takes four to six weeks for your cervix to heal after treatment. To reduce your risk of infection, we’ll advise you not to swim or take a bath for 2 weeks, not to use tampons for 4 to 6 weeks, not to have sex for 4 weeks, and not to exercise or do heavy housework or anything physically tiring for 3 to 4 days, or while there is still bleeding or discharge.
When will I get my results?
We’ll send a copy of your colposcopy report to your GP, and a copy of your results to you and your GP.
- If you had a biopsy, you’ll get a letter with these results usually within 4 to 6 weeks. The letter will advise you of the next steps and whether you need to have a follow-up appointment or return to the care of your GP for follow-up screening in 3 years.
- There are no results if you have cold coagulation treatment because a biopsy is not taken. The clinic will tell you when to come back for your next appointment on the day of your treatment.
- If you had LLETZ treatment, you’ll get a letter with your biopsy results usually within 4 to 6 weeks after your treatment. We’ll tell you when you should come back for your next appointment. In most cases, the next step after a treatment is a follow-up appointment at the colposcopy clinic in 6 months.
Follow-up screening
You may need another cervical screening test within 6 to 9 months of treatment to check you no longer have HPV. This screening test is often done in a colposcopy clinic. The results of this screening test will help to decide what the next step is for you and whether you need further colposcopy or can return to the care of your GP. We’ll share your results with you and advise you of the next steps.
If you have any concerns or questions, contact your colposcopy clinic. We’re here to help.
- We have information about going for a colposcopy in easy-to-read, plain English and photo-story formats.
- Have you ever wondered what happens to your sample once you’ve had your cervical screening? Follow your sample from your cervical screening to your results
- When are you due? 7 things you should know about cervical screening in Ireland
- Did you know that Ireland is on track to eliminate cervical cancer by 2040? We have everything we need to prevent it – a vaccination, cervical screening, and access to timely treatment for those who need it.