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Colposcopy for Abnormal Cervical Screening Tests (Pap smears)

Having an abnormal Pap smear may cause anxiety for any woman. With state-of-the-art equipment to assess the cervix; diagnose and treat any abnormality; and provide you with the essential and accurate information for your set of circumstances, you can count on the team at Alana to always assist you and help you understand and manage the abnormality.

Abnormal CST and colposcopy

When abnormalities are found on your Cervical Screening Test, your GP may refer you for a colposcopy, which is a more detailed examination of your cervix, performed by a gynaecologist.

A colposcopy is a procedure that allows your Alana doctor to see a magnified view of the cervix, vagina, and vulval areas through a piece of equipment called a colposcope.  A colposcope is a high powered microscope that is attached to an external stand and connected to a powerful light.  The colposcope stays outside of the vagina and we use a speculum to allow a clear view of the cervix, vagina and vulva and look for abnormalities that are not visible to the naked eye. During the procedure, different liquids are applied in small amounts to highlight possible areas of abnormality.  It is also possible to take swabs for specific infections and to biopsy any abnormal areas to check for changes that require further investigation or treatment.

The procedure is short and takes approximately 10-15 minutes and is performed at the time of your consultation.

Why is a colposcopy performed?

Your doctor may have referred you for a colposcopy if a routine Cervical Screening Test reported abnormalities.  These abnormalities may range from inflammation, infection, pre-cancerous or cancerous changes in the cells of the cervix.  It is important to remember that cancer is rare and most of the changes noted at the time of a colposcopy will resolve spontaneously and require only follow-up checks.   There are times when further investigation such a biopsy or other treatment is required, however again, this is most commonly for a pre-cancerous change to prevent progression to a cancer.

What to expect during a colposcopy

Following your consultation with your Alana doctor, you will positioned on an examination couch and you legs will rest on the couch or be supported in stirrups that allows them to rest and improves visualisation of the cervix.   A speculum is then inserted into the vagina (the same instrument used during a Pap smear); this gently holds the walls of the vagina slightly apart so we can see the cervix.

The colposcope is then used positioned between your legs but does not touch you.  The magnification of the microscope allows the cervix to be seen clearly without coming into contact with you at all.   An initial check of the cervix is made, swabs may be taken to check for infection and a further Pap smear may be taken at this time.

Your cervix is then washed with a number of solutions – acetic acid (a mild vinegar solution) and iodine that allows abnormal cells to b seem more clearly.  Application of these solutions is with a cotton swab and may cause mild irritation and occasionally stinging.  You should not experience pain during their application.

If an abnormal area is noted on the cervix, then a small amount of tissue (a biopsy) may be taken for further assessment with the pathologist.  The biopsy will be taken using a special forcep that removes a very tiny piece of tissue at the area that appears most abnormal on the colposcopy.  This procedure may cause a localised short sharp sting, but is very brief.

What to expect following a colposcopy

A small amount of bleeding may follow the examination from either small blood vessels on the surface of the cervix or from where a biopsy has been taken.  Subsequent spotting may persist for several days following a colposcopy but should not be heavy.  Please use panty liners for hygiene and NOT tampons during this time.

There may be some cramping after a colposcopy, especially if a biopsy is taken.  This occurs because the touching of the cervix causing may lead to uterine contractions similar to period pain, and may be treated in a similar manner by using medications such as naprogesic, neurofen or ibuprofen.  You should not have sexual intercourse until any discharge stops, usually for the next 3-5 days.

Risks associated with a colposcopy

A colposcopy is a common procedure and there are few associated risks.  Occasionally when the cervix is touched there may be a sensation of nausea and faintness.  This occurs because of stimulation to nerve fibres in the cervix.  If this happens,  let your Alana doctor know the symptoms and the procedure will be stopped and you will simply remain lying down and observed until the sensation passes in a few minutes.

Other risks include infection of the cervix may occur, particularly after a cervical biopsy is taken.  This is uncommon and antibiotics are not required as a routine.  Infection may occur in the first 10 days following the procedure and if you have persistent or offensive vaginal discharge, heavy bleeding, high temperatures, or increasing pain you should contact your Alana doctor for advice on what to do.

Uncommonly, heavy bleeding may occur from the site of biopsy.  We will ensure bleeding from the site has settled before we let you go home, however if you experience heavy bleeding immediately following the examination you should contact your Alana doctor for advice on what to do.

Frequently Asked Questions

Do I need to continue to have cervical screening after hysterectomy?
If you have had a subtotal hysterectomy, where the cervix is left behind, then you will need to continue to have cervical screening at the routine intervals. You should consult your Alana doctor to ask how often these need to be taken. If you have had a radical hysterectomy for a cancer then you will need to continue cervical screening as directed by your doctor. If you have had any other type of hysterectomy and your cervical screening history has always been normal, then you do not need to have further cervical screening. If you have had abnormal cervical screening results in the past, then you should ask your Alana doctor if these need to be continued.
Can I have my cervical screening test with the clinical team?
Yes.  We do provide cervical screening tests in accordance with best practice from Australian guidelines.  Your primary care practitioner will usually perform this for you and send you reminders when this needs to be done.  If you are referred and need your usual cervical screening test (the old term was Pap smear) we can perform this for you.
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