What is colposcopy?
A colposcopy uses a powerful microscope to allow a closer examination of a women’s cervix as well as the vaginal canal and vulva.
Why do I need a colposcopy?
You may be referred for a colposcopy if you have had an abnormal screening result, either a persistent low grade abnormality or a high-grade abnormality. From December 2017 the cervical cancer screening programme changes, and anyone with a positive liquid based cytology (LBC) result will be referred for colposcopy. Pap smears will no longer be performed from December 2017 and LBC is available with a Medicare Rebate from May 2017.
HPV testing and pap smears are screening tests. A pap smear takes cell samples from the cervix to look for early changes preceding cervical cancer. However, a Pap smears has its limitations, it can sometimes miss abnormal changes. However, having an abnormal Pap smear certainly doesn’t mean you already have cancer. It just means we need more information.
A positive HPV test just indicates that you have encountered one of the many types of HPV. If you are HPV positive, then a further test called Liquid Based Cytology (LBC) will be automatically performed on the same sample. Women who have abnormal LBC will need a colposcopy. Colposcopy is a diagnostic test, meaning that it is a much better and more sensitive test. This is why an abnormal cervical cancer screening tests should be followed up by a colposcopy.
If however, you experience any abnormal symptoms, such as heavy menstrual bleeding, bleeding after intercourse, bleeding in between periods, or persistent spotting whilst on the contraceptive pill, a colposcopy examination is also needed, regardless of whether you have had a recent normal Pap smear.
A colposcopy can safely be performed in pregnant women and women with an IUD in situ.
Who does the colposcopy?
A specialist who has been accredited as a colposcopist will do your colposcopy at Clinic 66. This will be either a Sexual Health physician or a Gynaecologist (who holds the qualification of FRANZCOG), other specially trained doctors who have been assessed for competency. Do NOT have your colposcopy performed by a doctor who is not appropriately trained and accredited to do this procedure.
What does the procedure involve?
The procedure is very similar to a Pap smear, with a few extra steps. An instrument called the speculum (same as those used for Pap smears) is inserted into the vagina to locate the cervix. A gynaecologist may then use a solution over the cervix such as acetic acid (vinegar) or Lugols solutions (iodine) to help highlight any abnormal areas, and take a close look at the cervix under magnification through the colposcope. A biopsy, i.e. tiny tissue sample may also be taken for further analysis.
Will it be painful?
The colposcopy examination takes 10-15mins. You may experience some discomfort during the procedure but it should not be painful. At Clinic 66, you may choose to have the colposcopy as an awake procedure or under sedation (light anaesthetic) so that you don’t feel any discomfort during the procedure.
What happens after the procedure?
If abnormal cells are found on the biopsy sample, further treatment is most likely required. The type of treatment will depend on the level of abnormality, your gynaecologist will discuss this in further detail with you. Treatments may include:
- No treatment – for minor abnormalities, a follow-up repeat colposcopy and Pap smear at an earlier interval may be required.
- 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.
After these treatments, a follow-up pap smear and colposcopy will be necessary to ensure that all abnormal cells have been successfully removed.
How much will it cost and what is the availability for appointments?
Clinic 66 is a private medical facility, so there is a fee charged for all our services. We do not bulk bill. The cost of a colposcopy will depend on whether you have a biopsy taken and/or whether you have IV sedation. A large proportion of your costs will be rebated by Medicare (for those who hold a Medicare Card). For women who don’t hold a Medicare card, the costs associated with colposcopy are usually covered by Medical/Health insurance but it is best to check directly with your provider.
Clinic 66 are competitively priced compared with other providers and we have good appointment availability, and can usually see you within a week of your enquiry. Please call us for more information on (02) 9411 3411.