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Cervical screening (cancer prevention) & HPV

Human Papillomavirus (HPV) screening & Vaccination

Most cancer of the cervix is preventable. Australia has one of the lowest rates of cancer of the cervix in the world. The incidence has been reduced by 50% since the Pap test screening programme was introduced in 1991.

Now more than 80% of cancer of the cervix is diagnosed in women who have never had screening or overdue for screening.

 

Screening aims to detect the human papillomavirus (HPV) infection and cell changes on the cervix well before the development of cervical cancer.

In December 2017, the 2 year Pap test was replaced by the Cervical Screening Test (CST) every 5 years from the age of 25 to 74

 

The reasons for the change in the NCSP include:

  • increased knowledge about HPV and cervical cancer
     

  • better detection using modern technology (HPV testing and liquid based cytology) and
     

  • the introduction of the HPV Vaccination Program in 2007, aimed at preventing some types of HPV infection which cause 75% of cancer of the cervix.

You Can Now Collect Your Own Sample!

Not keen on a speculum examination? It's ok... we get it. But please don't let that stop you from caring for your health. Although clinician collected samples are our preferred 'gold standard' (because we often find issues other than HPV while doing the CST), you can now collect your own sample! 

No speculum

Provided your last test was clear or you haven't had a test previously, and as long as you don't have any symptoms, we can now offer you a 'self-collection' option either in the clinic, or at home via telehealth.

It's really easy to do - if you can insert a tampon, you can collect your own CST sample with a simple cotton swab. And it's just as reliable as a clinician collected sample for detecting HPV. 

 

But you still need to meet with your GP in order to receive the testing kit.

  • What is a Cervical Screening Test (CST) and what is the difference between clinician and self-collected tests?
    A CST is a vital preventive check to screen for Human Papilloma Virus (HPV) in the vagina and examine cervical cells. For normal results, it is usually recommended every 5 years. There are two collection options: Option 1: Clinician Collected CST Similar to the traditional Pap Smear. Clinician performs a speculum examination to collect a cervical sample with a brush. This is usually a quick examination and should not be painful. Liquid-based cytology sample sent for HPV testing +/- cytology testing. If HPV is detected the laboratory will automatically perform a cytology test too. Clinician collected CST can be used for routine screening, if there are symptoms or if a self-collected swab result detects HPV. Additional tests can be performed on the same sample such as STI screening. Option 2: Self-Collected CST Collect your own sample using a swab. This is inserted into the vagina and rotated around for about 30 seconds. Sample is for HPV testing only - you will need to return to the clinic for a speculum examination if HPV is detected on your self collect vaginal swab Only suitable for routine screening (last test was normal or for first-time screening). Only suitable if there are no symptoms Studies confirm self-collected samples are as reliable as clinician-collected ones for HPV detection. HPV self collection tests will not detect other abnormalities that may be detected during a speculum examination.
  • I'm not sure how long it has been since my last test, how do I find out?
    You can call the National Cancer Screening Register on Tel: 1800 627 701 Hours of Operation: 8am to 6pm in all Australian state and territory time zones. As a guide, when you call they may ask you for personal information to help identify you, for example first name, date of birth and Medicare identification. Or you can login to the participant portal at: https://www.ncsr.gov.au/information-for-participants/participant-portal/
  • Why Do We Need Cervical Screening Tests and What Is HPV?
    CSTs are vital to reduce cervical cancer risk and detect it early. They look for HPV, a common virus spread through intimate or sexual contact. Clearing HPV can take time, and some may develop abnormal cells, which, if left untreated, can lead to cervical cancer. Routine screening is crucial to prevention. More than 70% of people diagnosed with invasive cervical cancer are under-screened or have never screened You should still have cervical screening even if you have been immunised with the HPV vaccine as the vaccine does not cover all strains of HPV.
  • Am I Eligible for Self-Collected CST?
    Self-collection of CST is an option if you are due for your regular CST, or if you've missed it and are overdue. This means it's suitable for you if: Your last test was 5 years ago, and it didn't detect HPV. You've never had a CST before. Your last test was more than 5 years ago, possibly a Pap Smear (before December 2017), and you believe it was normal. However, self-collection of CST is NOT suitable for you if: You experience vaginal bleeding after sex (known as "post-coital bleeding"). You have vaginal bleeding between your periods (referred to as "intermenstrual bleeding"). You are post-menopausal, meaning it's been over 12 months since your last period, and you're experiencing vaginal bleeding ("post-menopausal bleeding"). You have unexplained, persistent, and unusual vaginal discharge. You have pain in your genitals or pelvis. You have any vulval symptoms that need examination You've had HPV in the past and need a test for cure. You have been told in the past that you have had cervical polyps You've been treated for adenocarcinoma-in-situ (AIS), a type of cancer. You've undergone a total hysterectomy (removal of the uterus and cervix) and previously been diagnosed with "high-grade squamous intraepithelial lesion (HSIL)." You've been exposed to diethylstilbestrol (DES) while in utero.
  • What Outcomes Can I Expect After Receiving My Self-Collect HPV Test Results?
    No HPV (>90%) = Rescreen in 5 years HPV Non-16/18 (~6-7%) = Clinician-collected sample needed for cell assessment. HPV 16 or 18 (~2-3%) = Referral for colposcopy, sometimes expedited with a clinician-collected sample. Visit the Cancer Council website for an easy to understand explanation about what your results mean.
  • What Outcomes Can I Expect After Receiving My Clinician Collected CST Results?
    Low Risk Result (89%) = Rescreen in 5 Years Intermediate Risk Result (8%) = Rescreen in 12 Months. Intermediate risk results usually mean that HPV non 16/18 has been detected but that the cytology test is normal or has low grade changes. Some tests are allocated as intermediate risk even if they are normal if the test is performed as follow up after a high grade abnormality. Higher Risk Result (3%) = Referral for a Colposcopy examination
  • Who Needs Cervical Screening Tests?
    Recommended for those: Aged 25-74 years Assigned female at birth With any form of sexual contact 5 years since last screening (minimum 57 months) Additional screening may be needed for specific conditions or situations e.g. immunosuppression. Tests can be performed outside of the screening age range if there are any symptoms such as abnormal bleeding.
  • Do I need to have an IUD insertion with sedation or can I be awake?
    The choice is yours. If you have intravenous sedation, you will have a brief, light anaesthetic and have no recollection of the procedure. You will need someone to drive you home, as you can’t drive on the day of a sedation anaesthetic. Commonly, those who have an IUD insertion (or removal) with sedation are women who: Are nervous or tense about being examined or having cervical screening tests Are only recently or never sexually active Have had surgery to their cervix, such as a LLETZ procedure Have ONLY had elective Caesarean section deliveries (without labouring) Are approaching menopause Want an IUD removed, but the threads cannot be seen in the cervix If you DO opt for sedation, then you should: NOT eat any food during the 6 hours prior to your appointment Drink only water between 6 and 2 hours before your appointment Have nothing pass your lips in the 2 hours immediately before your appointment (this means no food or dring and includes smoking, lollies and chewing gum) An awake IUD insertion procedure takes about 5-10 minutes and there may be some discomfort. We advise that you take some simple pain relief (the same as what you would normally take for period pain) about 30 mins before the procedure. Awake IUD insertion can also be performed using local anaesthetic and/ or a Penthrox inhaler (green whistle). Please note that for women who have NEVER been sexually active, we do not offer IUD insertion as an awake procedure ( must be booked under IV sedation) The doctor who performs your insertion procedure will discuss what kind of anaesthesia might be necessary.
  • Why should I use a condom for the week before my IUD removal or replacement?
    Please do not have condomless sex one week prior to the replacement OR removal of an IUD (as sperm can hang around, and this can result in an unintended pregnancy).
  • Do I need to have a GP consultation before having my IUD inserted?
    You do need to have a consultation prior to having your IUD inserted, which can be done with your own doctor, or one of our doctors or clinical nurse specialists. This pre-insertion consultation is important, as the timing of insertion, the type of device and anaesthetic options all need to be discussed. If you dont want to come into the clinic, you can have a consultation with one of our Telehealth doctors. Please make a booking at clinic66online.com.au
  • What do I need to bring with me?
    2 or 3 sanitary pads (light flow only) Some photo identification- a driver’s licence or passport Your Medicare card Warm, comfortable clothes and nothing that is too restrictive around the tummy A snack, or some food or drink for AFTER the procedure If you are travelling from more than 100km away, you should schedule yourself a telehealth consultation with one of our doctors prior to travelling, to ensure that you are suitable for an IUD procedure with us. We do not want to disappoint !
  • Do I need a pelvic ultrasound before my IUD insertion?
    If you have heavy periods are any abnormal bleeding (such as bleeding in between your periods), we need you to have a good quality Day 5-9 formal transvaginal pelvic ultrasound scan to make sure that there are no underlying problems. If needed, we can refer you for a pelvic ultrasound scan. Women in their forties who have heavy periods are likely to need to have a Pipelle endometrial biopsy, and there is an additional charge for this procedure. If you have had a termination of pregnancy (medical or surgical), and you haven’t yet had a period after the procedure and you wish to have an IUD inserted, you should have a pelvic ultrasound performed. Please send us the report prior to booking in for your IUD insertion.
  • What if I want my IUD removed or replaced?
    Removal of an IUD is usually quite straightforward, and can be done in the consulting rooms by a doctor who has experience at removing an IUD. If the IUD strings are not able to be found in the cervix, and you want to have your IUD removed, we need an ultrasound scan before we attempt to remove the IUD to ensure that the device is still in the uterus (womb). Please dont have unprotected sex for one week prior to the IUD removal or replacement, as sperm can hang around and its possible you could get pregnant once the IUD is removed, even from sperm which have been in the body for a few days.
  • Are there any reasons why a woman can’t have an IUD inserted?
    If you have a history of breast cancer, we will need a letter from your oncologist and/or breast surgeon to say that you are clear to have a hormonal IUD. If you have a history of uterine fistula or complex surgery to your uterus, an IUD may not be suitable (a previous Caesarean Section is fine). Large fibroids, unusual layout such as bicornuate uterus or any other problem which can distort the inside of your uterus (womb) might make the use of an IUD difficult. We will discuss your options with the report from a formal pelvic ultrasound. If you know you have an unusual uterus, please make an appointment to discuss your options PRIOR to booking in for your procedure. (We dont want you to waste your time by accepting your booking and then us not being able to help you) A pregnancy must be excluded before using an IUD, and that is why we like you to come in for an IUD insertion within 7 days of the start of your menstrual period. In that way, we know that you are not likely to be pregnant. However, if you do not get regular periods, you can still have an IUD inserted but the timing needs to be discussed with one of our doctors or nurses.
  • What are the risks?
    Every surgical procedure and anaesthesia has some associated risks. Vasectomy is a very low risk procedure but there is a risk that complications may occur including: Bruising: and/or mild swelling is quite common in the first week and will subside over 1-2 weeks. Bleeding: Superficial bleeding from the area where the tiny incision was made. This usually resolves with squeezing the skin and pressure. Deep Haematomas: are a larger deeper collection of blood in the scrotum which results from over-exertion and a blood vessel bleeding internally. This can be as large as a grapefruit and can take up to 3 months to resolve. Wound infection: infection can occur around the 1 week mark after the vasectomy in 1% or less of men. It may present as a tender, swollen, or red area in the scrotum and/or fever. It generally requires antibiotics. Sperm Granuloma: This is a small inflammatory area which can occur as a result of sperm being released at the end of the tube. It resolves over time. Congestion: A sense of pressure caused by sperm in the testes and epididymis may cause some discomfort for some 2 to 12 weeks after your vasectomy. Congestion resolves itself in time. Post Vasectomy Pain Syndrome: Less than 1% of men may develop an ongoing scrotal pain usually unilateral. Discomfort or pain may be felt in the scrotum, back and/ or lower abdomen. This usually responds to anti-inflammatory medication and resolves spontaneously. Very occasionally additional surgery is required. Failure: Re-joining of the tubes sometimes occurs within the first 2-3 months and is picked up by the 3 month sperm test. Late failure after 3 months is extremely rare.
  • Is my medical history important?
    Any man can have a vasectomy, but we do need to know about any previous surgery on your testicles or about any procedures for hernia repair. Scar tissue from these procedures or obesity can make a vasectomy more complicated, and if so, you may not be suitable to have a vasectomy as an office based procedure. Please also tell us of any other significant conditions such as chest or heart problems or other serious illness. It shouldn’t affect your procedure, but it’s important for your safety that we are aware of such conditions. You should NOT take aspirin,anti inflammatory medication, steroids, antiplatelet drugs, any kind of blood thinning medication including fish oils for one week prior to a vasectomy. If you are not sure, come and see one of our doctors before booking in, for a consultation.
  • Do I need my partner's consent to have a vasectomy?
    Only you can decide whether or not to have a vasectomy – our service is completely confidential. However, if you are in a relationship, we would always advise that you discuss such an important decision with your partner.
  • Does the vasectomy work straight away?
    No, you won’t be sterile right away. There will be some sperm left in the upper part of the vas deferens, beyond the vasectomy site. These sperm are gradually cleared after ejaculation over some weeks. You will need to use another method of contraception for at least 3 months and until your doctor informs you that your semen is free of sperm. Three months after the vasectomy, we will ask you to supply a semen sample which is checked under a microscope to see if there are sperm. This test is very important. It can take up to 25 ejaculations to clear the tubes of sperm completely, so we may have to ask for a second sample if the first one is not yet clear. When you have given a semen sample which has no sperm present, we’ll write and inform you that your vasectomy has been a success. Note that frequent ejaculations help to clear the sperm from your tubes faster. It is important to note that even once you’ve been given clearance, there is still a small chance of late failure. This will be explained during your preoperative consult.
  • Will vasectomy protect me from STIs?
    No. Vasectomy cannot protect you against HIV or sexually transmitted infections (STIs). Condoms are the best protection against STIs if you are sexually active and have casual partners.
  • When can I play sport again
    You can do gentle exercise such as limited walking in the first week. You should avoid physical strenuous sports for at least two weeks (no cycling for 3 weeks) and contact sport 4 weeks. Keep the wound area clean and dry for 1 week after vasectomy. Please ask if you are unsure about any particular activity.
  • How much time will I need to take off?
    You will only actually be at the centre for about an hour (or two if you have iv sedation) but it’s a good idea to take things easy for a day or two. You might want to take a couple of days off work. If your work is very physical you will need to take a week off and then light duties for one week. We are happy to give advice about your particular situation and can organise a medical certificate if you need one. You can drive home after your procedure if you have had a local anaesthetic. If you have conscious IV sedation or Penthrox, you should arrange for someone to collect you as you cannot drive until the next day.
  • How do I prepare for my procedure?
    To prepare for your vasectomy, please follow these important instructions: Do not take painkillers such as nonsteroidal anti- inflammatory drugs (NSAIDs) i.e ibuprofen (Nurofen®), or aspirin, for one week before your procedure. You may take Paracetamol based painkillers (such as Panadol or Panadeine). Do not drink alcohol 24 hours before your procedure. You must shower the evening before, and again on the day of your procedure. Trim hair over entire pubic area with nail scissors. Please shave the scrotum and upper thigh area completely, so there is NO HAIR whatsoever on your scrotum. You can consult 'Youtube' for how to do this. See: Manscaping. Shaving down there Wear firm fitting underwear on the day of your procedure. (ie: do not wear boxer shorts). If you choose to undergo conscious IV sedation you must not eat anything (including lollies or gum) for 6 hours prior to your appointment. You may drink small amounts of water only, but no other fluid, up to 2 hours before your appointment. If you choose the local anaesthetic option you may have a light breakfast of tea/coffee, juice, toast or cereal. If you are unsure or need further clarification, please contact us on (02) 9411 3411.
  • How effective is vasectomy?
    Vasectomy is probably the most effective method of contraception that exists. The failure rate is much less than 1%. Sometimes the sperm-carrying tubes can re-join, however this risk decreases rapidly as healing proceeds. Don’t rely on it as a form of contraception until you have produced a semen sample and “been given the all clear” (this will be at least 3 months after the procedure).
  • What can I expect from a typical appointment?
    All men have a pre-operative consultation with a doctor to discuss the decision and to talk about the procedure and go through the consent form and be examined. This is a chance for you to ask any questions or raise any concerns. Your partner is very welcome to attend this session with you, if you want her to. Following the procedure, we provide an aftercare service and advice free of charge when required. If you have any questions, just call the clinic on (02) 9411 3411.
  • Is vasectomy reversible?
    Vasectomy should be considered a permanent form of contraception. If you are not sure whether you want to be able to continue to father a child by natural methods, dont have one! However, there are ways of fathering children such as ICSI or vasectomy reversal of a vasectomy. You can also freeze sperm, but storage costs will be incurred. Reversal and ICSI ( reproductive technology as part of IVF) is very expensive (over $6000), particularly if you do not have private health insurance. It may not be successful
  • Does having a vasectomy increase my risk of cancer?
    There is no conclusive evidence linking vasectomy to cancer of the prostate or testicles. However we advise all men, whether or not they have had a vasectomy, to have regular health screenings. It’s also important to get into the habit of regularly checking your own testicles for lumps or hardness.
  • Will having a vasectomy affect my sex life?
    With no change to your hormones, ejaculation or orgasm, there’s no reason why having a vasectomy should have a negative impact on your sex life. In fact, many couples find vasectomy improves their sex life, enjoying greater sexual freedom once they no longer have to worry about an unplanned pregnancy. You have erections as normal. After your vasectomy you can resume usual sexual activity 5-7 days later
  • How will my vasectomy affect my body?
    Your testicles will continue to produce sperm but, because the sperm can’t get through the tubes any more, they simply get reabsorbed into the body. Vasectomy does not affect your male hormones, nor does it affect ejaculation. The only difference when you ejaculate is that there will be no sperm in the fluid (sperm only make up about 3% of semen volume). Vasectomy will not affect your erection!
  • Are there any alternatives to vasectomy?
    There are still very few methods of contraception for men – either vasectomy or condoms. However there is a permanent procedure for women – female sterilisation. Female sterilisation is usually carried out by “tubal ligation” (having tubes tied) which requires hospital admission and general anaesthetic. There are also other very effective long-term (but not permanent) alternatives your partner could use. These include intrauterine devices (IUDs), contraceptive implants or injections. If you have doubts about whether or not you will want to have children in the future, you should consider reversible contraception. We will be able to advise you and your partner on alternative contraceptive methods to suit your circumstances. Make an enquiry (no referral required) to speak to some of one of expert doctors who can help you decide which contraceptive option is best for you.
  • Does it hurt?
    Each person is different and we cannot guarantee you will feel no discomfort. Generally speaking, the injection of local anaesthetic brings a brief stinging pain, but it starts working straight away and will make the area feel numb. You may then have some sensation of pulling or pinching during the procedure, but this should not be painful. You can opt to have IV sedation and you probably won’t feel anything or remember anything at all. You can opt for inhaled anaesthetic using a “green whistle” (penthrox) which provides excellent pain relief without intravenous sedation. You may feel some slight discomfort after the vasectomy but ordinary painkillers and a cold pack will help, and any soreness shouldn’t last very long.
  • What anaesthetic options do I have and which one is right for me?
    Intravenous (IV) Sedation Vasectomy under IV sedation is ideal for men who prefer not to be awake for the procedure. IV sedation is a gentle, clean, mild anaesthetic, which is generally tolerated well, though you cannot drive for 24 hrs post sedation (due to impaired reaction time). This is not a full general anaesthetic but does ensure that you are comfortable, relaxed and pain free during the procedure. This option is preferred by most men, and carries a higher Medicare rebate. It is particularly helpful for men who feel anxious, as the sedation helps them (and their scrotum) relax. Normal diet up to 6 hours prior to appointment. Clear fluids only for 6-2 hours prior to procedure. Completely Nil By Mouth ( nothing to eat OR drink) for 2 hours prior to the procedure You will be at the clinic for approximately 2-3 hours in total. You cannot drive after the IV sedation so you will need to arrange a lift home. Vasectomy with Green Whistle (Penthrox Inhaler) This is an option for men who do not wish to have intravenous sedation but would prefer something more than just local anaesthetic. It consists of inhaled quick acting anaesthetic and provides excellent pain relief. You will need to have someone drive you home. Fast for two hours (ie nothing to eat or drink). You will be at the clinic for approximately 2 hours. Vasectomy with Local Anaesthetic Only Local anaesthetic is delivered though a tiny needle and provides numbing directly to the area where the vasectomy is performed. You will be completely awake during the whole procedure, and may be aware of a pinching sensation, though this is only brief. Local anaesthetic is ideal for men who need to drive within 24 hrs of the procedure, or who don’t like the idea of being asleep. You will be at the clinic for approximately 2 hours. Please have a light meal before attending for your operation but fast for two hours immediately prior to your appointment (ie nothing to eat or drink}. You can leave on your own and drive yourself home if you have a local anaesthetic.
  • How is the procedure carried out?
    A local anaesthetic injection numbs the area and a very small incision (approx. 5mm) is made in the front of the scrotum. Through this opening, each vas deferens (tube) is cut and sealed off (see diagram). Once this heals you will have a very small scar on the scrotum which will become invisible soon after the procedure.
  • How much does it cost?
    The cost of a vasectomy varies. If you have a Medicare card, some of the cost will be covered by Medicare. As with most other private medical treatments or day surgery procedure there is a theatre fee and a gap between what Medicare will reimburse and the cost. You do not have to pay hefty hospital fees when you attend our clinic. Costs are a little higher on Saturday than during the week. For an accurate cost relevant to your circumstances, talk to us on (02) 9411 3411.
  • How effective is it? What is the success rate?
    Approx. 85% of women are satisfied or very satisfied with the results of the treatment. Conditions which improve are dryness, itching, burning, painful sex, vaginal discharge, reduced frequency of urinary tract infection, and laxity. The treatment is very safe with no “downtime “apart from not being able to have sex for one week after treatment.
  • How many sessions will I require?
    Most women start to feel the benefits after their second treatment. Three treatments six weeks apart are recommended for the initial course. Most women then need a “top-up” after one year, and annually thereafter. Some women need more treatments if symptoms are severe.
  • How long does the procedure take?
    The first appointment and treatment take about one hour. Subsequent sessions take about 30 minutes
  • When can I book an appointment?
    Consultations (essential for each treatment) are separate from the Mona Lisa Touch treatment, though can happen at the same appointment. Good days to come in are Tuesday and Wednesday but we can also accommodate you on other days. All our doctors are specialised in the management of women’s health issues, and our clinic will give you excellent service at an affordable price. No referral is required.
  • Do I need to do anything to prepare for the procedure?
    If you use vaginal oestrogen (pessaries or cream), please stop using for one week prior to your treatment. If you are menstruating, it is best to delay the procedure until you stop bleeding. You can drive after the procedure (no need for a support person as we only use local anaesthetic).
  • Am I suitable for the procedure?
    You will need to book a consultation with one of our doctors to discuss this.
  • What happens during the procedure?
    The doctor will undertake a consultation to determine if you are suitable for the procedure. The actual procedure is like a long pap smear using special equipment which includes a medical laser. Some topical anaesthetic cream is used around the vagina. Most women remain comfortable during the procedure and require no pain relief.
  • Do I need a referral from my GP?
    No. As with most Clinic 66 procedures, no referral is required.
  • How does MonaLisa Touch work?
    Mona Lisa Touch rejuvenates vaginal tissues by promoting collagen formation. By delivery of exact amounts of laser energy into the layers of the vaginal mucosa and vulval skin, new cell growth is stimulated. It is often referred to as “anti-ageing for the vagina”.
  • How much does MonaLisa Touch cost at Clinic66?
    $650 per treatment. Unfortunately, no rebate from Medicare or Health Funds is available at this stage (Mona Lisa Touch treatment is an innovative treatment and the medical administrative establishments have not caught up yet!). If you do not hold a current Medicare card, there will be an additional fee for the consultation.
  • How Much Does a Surgical Abortion Cost in Australia?
    The cost of a surgical abortion will vary depending on the practice you visit, but on average, you can expect to pay out of pocket $450 at the low end with health care coverage, and approximately $1,200 for non-Medicare patients (though some private insurers will cover abortion care) . Consult with Clinic 66 about your circumstances to get an accurate estimation of your upfront and out of pocket costs.
  • What to Expect During the Procedure?
    So, what can you expect during a surgical abortion procedure? It is most commonly a day procedure, and you will, in most cases, be put under intravenous sedation. The procedure is not a lengthy one, with the total time at the hospital or clinic being only around 3 hours maximum. The overall experience of the procedure depends on what stage of your pregnancy you are at. Pregnancies that are under 12 weeks since conception are the most simple, requiring only 15 minutes to perform the procedure, while pregnancies within the second trimester require more time due to a more complex procedure. The expert team at Clinic 66 can answer any questions you may have about surgical abortion procedures. Reach out to our professionals today to book a consultation.
  • What is a Surgical Abortion?
    Surgical Abortion is an efficient, simple, dependable and safe method of terminating an unplanned pregnancy. This process utilises surgical techniques, rather than medication alone, and is overseen and performed by a highly trained healthcare provider. At Clinic 66 in Sydney, we gently remove the pregnancy tissue from the uterus using surgical abortion techniques. The procedure is uncomplicated and takes on average 10 to 15 minutes, with twilight sedation utilised so you feel no pain and have zero memory of the procedure. If you are considering this procedure or need further information about the services we offer, please contact our team to organise a consultation with a professional.
  • When is a Surgical Abortion Performed?
    In Australia, you can have a surgical abortion in all states and territories, though there are some minor legal differences across state borders. There is still sadly a lack of access to public hospitals all over Australia For speed, convenience and discretion, you may want to visit a community day surgery like Clinic 66 as we dont require a referral ; you can make the appointment yourself to come and see us. . In terms of how early you can have the procedure performed, it comes down to when your pregnancy has been confirmed. It usually takes around 6 weeks after your last menstrual period for a pregnancy to show up on an ultrasound, and the procedure won’t be able to go ahead without this confirmation first. When deciding to go ahead with a surgical abortion procedure, it’s important to note that procedures performed within the second trimester are often more complex than those in the first trimester. If you are considering a surgical abortion, please reach out to the professional team at Clinic 66 to discuss how to proceed and what makes the most sense for you.
  • Types of Surgical Abortion Procedures?
    There are several different types of surgical abortion procedures, with different options considered depending on how far along in the pregnancy period you are. Suction Aspiration (Vacuum): To have this procedure performed, you must be in your first 12 weeks of pregnancy. This option involves the use of a gentle suction to remove the pregnancy tissue from the uterus. The operation takes less than 15 minutes on average. Dilation and Curettage (D&C): The cervix is dilated through the use of an instrument called a dilator. Surgical instruments, along with suction, are utilised to remove tissue from the uterus. This procedure is often used as a diagnostic procedure to check the endometrium, but is also used after a miscarriage as well at times. Dilation and Evacuation (D&E): This procedure is often used for pregnancies that are further along, around the 14 to 16 week mark. Suction and medical tools are used in conjunction to remove contents from the cervix , which will be dilated throughout the procedure. If you are considering any of the above three options, please reach out to the professional team at Clinic 66 to discuss how to proceed and what makes the most sense for you. In addition to surgical procedures, some patients may be eligible for a abortion Sydney option using medication, depending on the stage of pregnancy and personal preferences.
  • Surgical Abortion vs Medical Abortion
    A medical abortion (MTOP) uses prescription medication to end a pregnancy and is available up to 63 days (9 weeks) of gestation. It involves taking two medications: the first medication blocks the pregnancy hormones and stops the pregnancy from growing, and the second, taken 24–48 hours later, causes the uterus to expel the pregnancy. It’s a low-risk, non-invasive option that can be completed largely at home, with around 95–98% effectiveness. However, some people may experience side effects such as cramping or prolonged bleeding, and a small percentage may need follow-up treatment or a surgical procedure if the abortion is incomplete. A surgical abortion (STOP), on the other hand, is a quick and highly effective procedure (over 99% success rate) carried out in a clinic or hospital. It involves removing the pregnancy using gentle suction and typically takes 10–15 minutes, with a total clinic stay of about 3 hours at Clinic 66 . It’s considered one of the safest medical procedures in Australia, especially in the first trimester. Recovery usually takes 1–2 days, with light bleeding for up to two weeks. While both options are safe, the choice depends on your stage of pregnancy, access to care, and personal preference. Emotional support is also important — many clinics, like Clinic 66 and Clinic 66 Online, can connect you with counselling and aftercare resources.
  • Is a Surgical Abortion Painful?
    The majority of surgical abortions are not painful due to almost all procedures being performed under intravenous sedation. Some women may experience pain after the procedure due to cramping, but this can be easily managed with over-the-counter medication such as ibuprofen, and a heat pack.
  • Is Surgical Abortion The Right Choice For You?
    The decision to undertake a surgical abortion is a deeply personal choice. It depends on a variety of different circumstances. Consider your personal situation, general health, gestational stage and overall preferences. Remember, there is no wrong decision here; this is your choice. Surgical abortions offer a safe, effective, and quick option for terminating a pregnancy, with minimal recovery time afterwards required. Some individuals may prefer a medical abortion Sydney option, depending on how far along they are and their personal comfort with the process. At Clinic 66, we are backed by a team of passionate and experienced medical professionals, so you always know you’re in the best hands in Sydney. Contact us today to book in a consultation or have any questions you may have answered. Remember, you are not alone; support is available, and we will help you every step of the way.

Frequently Asked Questions about Cervical Screening & Self Collection

Self Collected Cervical Screening Test

Does the HPV virus cause cancer?

You can get HPV by having direct genital skin contact with an infected person. Sexually transmitted HPV can occur with vaginal, oral, anal sex or genital to genital skin contact without penetrative sex.

Genital HPV infection is often transient, causes no symptoms and resolves spontaneously.

 

Some types of HPV may cause simple genital warts (condylomata). Genital warts are usually caused by low risk HPV types most commonly HPV types 6 and 11.

More than 99% of cancer of the cervix is due to high risk or oncogenic HPV.

 

There are about 14 high risk (or oncogenic) types of HPV. This means they can be associated with cancer of the cervix. Oncogenic HPV types 16 and 18 cause about 75 % of cancer.

If high risk (oncogenic) HPV causes a persistent infection of the cervix, cell changes such as CIN3 (cervical intraepithelial neoplasia) and even possibly cancer can occur. These changes usually occur slowly over many years.

Persistent infection with high risk HPV can also be associated with other cancers such as vulvar, vagina, cervix, anus, penis, mouth and throat cancers.

hpv-vaccination-clinic66

There are over 100 types of human papillomavirus (HPV) and around 40 can infect the genital region via sexual contact. HPV infection is very common - 80 % of men and women who have ever been sexually active have been exposed to HPV.

What are the changes to the NCSP?

 

The Pap test has been replaced by a Cervical Screening Test (CST). The CST looks for the presence of HPV. This new CST is an improved, more sensitive test than the previous Pap test

Cervical screening

Though you will be charged a consultation fee, your cervical screening pathology cost will be bulk billed to Medicare (see "Important Notice" below).

 

If you don’t have Medicare cover, we can still do cervical cancer screening for you, but there may be a small cost for the lab tests. These are usually covered by private health insurance.

The CST is an HPV test and if HPV positive, the sample is checked automatically for cell changes. This test is only available for people with a cervix.

There is no HPV test for males. HPV testing is not included in a screen for sexually transmitted infections.

  • It is now only necessary to have the new CST every 5 years, which is safer and more protective than having a Pap test every 2 years.

 

  • Women will be invited to have a screening test from the age of 25 and have their last screening test between 70 and 74 years of age.

 

The experience of having a Cervical Screening Test (CST) is the same as the Pap test  which involves a pelvic examination with a speculum insertion in the vagina to view the cervix and a sample taken. This examination should not be painful or uncomfortable, and all our doctors or practice nurses are experienced in conducting this examination and taking a CST.

And you now have the choice to take your own sample if you are eligible. Click here to find out more >

IMPORTANT NOTICE REGARDING MEDICARE REBATE: 

 

Medicare eligibility rules for Cervical Screening Tests changed in Dec 2017.

 

Some women may not be eligible for a Medicare rebatable cervical screening test if they fall outside of the screening age range (25Y - 74Y) or present sooner for a re-test than recommended. This may result in a pathology bill being received from the pathology provider. 

 

Clinic 66 is not responsible for checking eligibility for Medicare rebates for cervical screening, please check your eligibility with Medicare.

Is it safe to wait until 25 for the first Cervical Screening Test?

It is safe to have a first Cervical Screening Test at the age of 25 years because:

  • Cervical cancer is very rare in young women
     

  • The cervical screening program has not been shown to make a difference to the detection of cervical cancers in this age group
     

  • We now know that HPV infection and cervical abnormalities are common in young sexually active women. These abnormalities in young women usually clear without treatment.
     

  • Young women are protected by the HPV vaccine which includes 2 types of HPV that potentially cause 75 % of cancer of the cervix.

Professional Young Woman

However, you may be eligible to have a cervical screening test if you are younger than 25 years old and have:

  • experienced first sexual activity before 14 years of age or
     

  • have an illness or are on medication affecting your immune system.

Remember if you are a woman aged younger or older than age 25 years old, it is important to report to your doctor any abnormal vaginal bleeding ( eg bleeding after intercourse). This may be a sign of an abnormality on the cervix.

What if my Cervical Screening Test is Positive!?

dr-boulton-analysing-results

If HPV is found on your screening test, further action will be taken.

This may mean having a repeat test at a shorter interval, or it may be that a colposcopy is required to provide more information.

 

Our doctors and nurses are very happy to answer any questions you may have about your results, cervical screening tests and how the programme has changed.

If you have an abnormal test, and HPV and/or abnormal cells are detected, it may be necessary to take a closer look at your cervix to get more information. This might involve a colposcopy.

Colposcopy involves a speculum insertion into the vagina (like the CST examination) and a high powered binocular microscope (colposcope) is used to examine the vulva, vagina or cervix.

 

Colposcopy may involve using acetic acid and iodine washes and using coloured filters to properly examine the tissues under high powered magnification.

 

It may be necessary to take a biopsy, in order to provide information about abnormal-looking cells. For instance, if HPV has been found and abnormal cells indicate pre-cancerous or cancerous change, then a biopsy taken at colposcopy will help the gynaecologist decide what, if any treatment is required.

Colposcopy can be performed on pregnant women and women who have an IUD. Tell your gynaecologist if you think you might be pregnant or if you have an IUD.

By screening and closely observing and/or treating, the transition of abnormal cells to cancer cells is stopped, and cancer does not develop.

Note: It is very easy to screen for other infections, (such as chlamydia) at the same time as a Cervical Screening Test is performed.

Treatment options after a colposcopy ~ what happens next?

 

If abnormal cells are discovered on the cervix, further investigation maybe required. This may include colposcopy and possibly biopsy which will enable the gynaecologist to gather more information regarding the abnormal cells, and will dictate what type of treatment should be given.

Treatments  options which are recommended for abnormal cervical cells include the following:

  • No treatment (for minor abnormalities). A check screen for cervical abnormalities may be offered sooner than usual.
     

  • LLETZ procedure (Large Loop Excision of Transformation Zone). This takes about 20 minutes and involves a wire loop removing the area which contains the abnormal cells.
     

  • Cone biopsy. This is when abnormal cells are higher up inside the canal of the cervix.
     

  • Laser treatment.
     

  • Hysterectomy. This is the last option, and is for women who have already developed cancer of the cervix.

Colposcopy Q&A's with Dr Lynne Wray, Sexual Health Physician and diagnostic colposcopist

Colposcopy is delivered by our in-house, accredited colposcopists (gynaecologists and sexual health physician), and can be performed with sedation (inhaled or intravenous) if you prefer .

HPV Vaccination helps prevent cancer

In 2007, Australia led the way with a National HPV Vaccination Programme aimed to prevent infection with 4 types of Human Papilloma Virus (HPV). It aims to reduce HPV infection and  the number of abnormal cervical screening tests as well as genital warts.

However, all women still need to have cervical cancer screening, even if they have had the HPV vaccination, because the vaccine doesn’t provide protection against all types of HPV that can potentially cause cancer.

In 2018, a new HPV vaccine was introduced in Australia. It is capable of vaccinating against 9 types of HPV and aims to reduce the incidence of cancer of the cervix by 93%.

Cervical Cancer Screen and HPV vaccination at Clinic 66 Chatswood

The new HPV vaccine protecting against 9 types of HPV, is now used in the school based HPV immunisation programme. It will also be available to other men and women.

Who needs to have HPV vaccination and why?

HPV4U?

There are usually no symptoms from the HPV infection. Sometimes people may develop warty skin lesions if they have contracted sub-types 6 or 11, but people can be infected with HPV and never know it.

Anyone who has sexual contact can get infected with HPV. Often people get it soon after having sex for the first time.

 

The more sexual partners a person has, the more chance they have of being infected with a number of different types of HPV.

 

However, people who have only had one partner, people who haven’t had sex for a long time, and people who use condoms can still be infected with HPV.

HPV vaccination can protect you from being infected with some of the most common types of HPV that can cause genital warts and cancer.

The HPV vaccine is best given to young males and females before they become sexually active. In Australia, the HPV vaccination is available free to all girls and boys of 12-13 years of age and young people up to 19 years old who missed the school based HPV vaccination. Please ask us if you have any questions about the HPV vaccination.

 

There are also potential benefits from vaccinating people who have already become sexually active, as they may not yet have been exposed to the types of HPV which cause harm and maybe at risk of future exposure to HPV. Unfortunately, HPV vaccination does not provide any protection or treatment against the sub-type of HPV used in the vaccine, if the person has already been infected with it.

The HPV vaccine is safe and effective with very few contraindications and is an inexpensive and effective way to protect against cancer!

The cost of the course of 3 doses of HPV vaccine (for those not eligible for the free vaccine) is relatively low (about $450 for the full course of 3 injections),

Last updated on 11/09/2023

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CONTACT DETAILS

31 Bertram St, Chatswood NSW 2067

info@clinic66.com.au

02 9411 3411

If you call us out of normal business hours, your call will be answered by our after-hours on-call doctor service, who will attend to and triage your call. If appropriate, a doctors home visit may be offered. 

 

In the event of an emergency, the closest emergency department is Royal North Shore Hospital,  located at Reserve Rd, St Leonards.

OPENING HOURS

Monday to Friday

8am till 5:30pm

Saturday

8am till 4pm

Our private, specialist GP services are available via appointment only, and unfortunately we cannot accept patients via ‘walk in’. 

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