What happens at the Colposcopy Clinic?

Gynaecology Outpatient Department

Why have I been referred to the colposcopy clinic?

You may be referred to the colposcopy clinic for one of the following reasons:

• your cervical sample (smear test) has shown abnormal cells

• your GP is concerned about the appearance of your cervix

• your GP has difficulty obtaining a cervical screening sample

• you have irregular bleeding and/or bleeding after sexual intercourse.

What does abnormal cells mean?

The reason most women are referred to the colposcopy clinic is because their cervical sample result has shown abnormal cells, this is known as dyskaryosis. This could mean that there are pre-cancer cells present. This is called Cervical Intra-epithelial Neoplasia (CIN).

Pre-cancerous cells could turn into cancer if left untreated. They are divided into two categories:

Low Grade Dyskaryosis (CIN 1)

Most cases of CIN1 heal naturally. Because of this, monitoring is recommended.

High Grade Dyskaryosis (CIN2/3)

They have a higher tendency to turn into cancer. Because of this, treatment is recommended.

Sometimes the cervical sample is reported as Borderline changes, which usually describe the most minor grade of abnormality where cells are considered to be not normal but not abnormal enough to be classified as a pre-cancerous CIN change.

It is important for you to attend your appointment so we can have a closer look at your cervix (neck of womb). You are very welcome to attend the clinic with a friend or relative if you wish.

When you come to the colposcopy clinic, the doctor or nurse colposcopist (this person is trained to examine the cervix) in the clinic will examine the cervix.

If your cervix shows the changes associated with abnormal cells, then you will be recommended to have a biopsy taken or to have treatment.

It is highly unlikely you have cancer.

What is a colposcopy?

Colposcopy is an examination of the cervix, vulva or vagina using a colposcope (a colposcope is a type of microscope. It looks like a pair of binoculars on a stand).

The colposcope does not touch you or go inside you but allows the colposcopist to look at your cervix under magnification.

What happens when I come for colposcopy?

To prepare for the colposcopy, you may find taking simple painkillers such as Ibuprofen or Paracetamol tablets about 1 hour before your appointment may help. You should always follow the instructions provided in the leaflet supplied with your tablets.

The colposcopist will need to ask some questions about your periods, contraception, medical and surgical history.

Before the colposcopy examination, you will be asked to undress from the waist downwards in a private room. You will be provided with a hospital gown but you may wish to wear a loose skirt or dress so you do not have to remove all your lower clothing.

A nurse will help you to position yourself on the examination couch and will ensure you are comfortable throughout the procedure. The colposcopist will put a speculum inside the vagina (just like when you had the smear) and will place some solution onto your cervix to help identify the abnormal cells.

If the colposcopist recommends a biopsy (a small sample of tissue), they will explain that to you before performing the procedure. If this is needed, you will be given a leaflet explaining this in more detail.

You will not need a local anaesthetic for this minor procedure. However, if you need treatment, a local anaesthetic will be given.

There will be a screen where you can watch the examination and procedure if you wish. In some occasions the colposcopist might ask your permission to take some pictures for medical records and teaching purposes. You may decline if you do not wish to.

Your sample(s) or tissue may be stored to allow us to check your test results again, if needed at a later date. Sometimes samples taken may be used for teaching, research or public health monitoring in the future interests of all NHS patients. Samples kept for this purpose will not identify you. You have the right to refuse consent for samples of your tissue to be used for teaching or research purposes. If you refuse consent; this will not affect your treatment in any way.

How will I feel when I go home?

You may have some discomfort for 1 – 2 days after this procedure.  Taking painkillers such as Paracetamol or Ibuprofen can help.  Always follow the instructions provided in the leaflet supplied with your tablets.

After your procedure you may also have mild bleeding and a watery brown discharge from your vagina for up to 4 weeks.

If:

• you have any heavy bleeding

• you have any discharge with an unpleasant smell from your vagina

• you feel feverish, unwell or develop a high temperature

• your pain increases

you should contact your GP or the Outpatient Department where you had your procedure for further advice (See contact numbers).

If the bleeding becomes heavier following your LETZ treatment, you must contact your GP or the Outpatient Department where you had your procedure for further advice.

If you cannot contact your GP or the Outpatient Department is closed, you should contact the Accident and Emergency Department at your local hospital for advice (See contact numbers).

What can I do to help myself?

To help your cervix heal, you should avoid sexual intercourse, use of tampons or swimming until the bleeding and discharge has stopped. This might take up to a week after having a biopsy taken and up to 4 weeks after having treatment.

When can I return to my normal activities and work?

You can usually return to all of your normal activities and to work straight away, or as soon as you feel well enough. You should discuss any concerns you may have with your nurse or doctor.

Will I need to return to hospital?

Your nurse will tell you if you need to be seen again in the Outpatient Department and if so will either:

• ask you to make another appointment before you go home

• arrange for an appointment to be sent to you through the post.

If you have any worries, please contact the Outpatient Department.

When will I be told the results of my biopsy?

Your biopsy will be sent to a laboratory. It can take up to 4 weeks to get the results of these tests. Your nurse will tell you how you will receive your results. This will be either:

• in a letter sent to you through the post

• discussed with you during your next outpatient appointment.

Your GP will also be sent a letter explaining the results of your biopsy.

Contact numbers

If you need further advice or have any problems, please contact the appropriate number below.

University Hospital of North Tees

Outpatient Department

Telephone: 01642 624172
Monday – Friday, 9.00am – 5.00pm

Accident and Emergency Department

Telephone: 01642 382899
24 hours a day, 7 days a week

University Hospital of Hartlepool

Outpatient Department

Telephone: 01429 522868
Monday – Friday, 9.00am – 5.00pm

If you have any worries or concerns, you should contact your GP during normal surgery hours. Outside surgery hours, you should contact your GP’s surgery for the Out of Hours Service number.

Further information is available from:

NHS Choices

Telephone: 111 (when it is less urgent than 999)
Calls to this number are free from landlines and mobile phones
Or via the website at www.nhs.uk

Comments, concerns, compliments or complaints

Patient Experience Team (PET)

We are continually trying to improve the services we provide. We want to know what we’re doing well or if there’s anything which we can improve, that’s why the Patient Experience Team (PET) is here to help. Our Patient Experience Team is here to try to resolve your concerns as quickly as possible. The office is based on the ground floor at the University Hospital of North Tees if you wish to discuss concerns in person. If you would like to contact or request a copy of our PET leaflet, please contact:

Telephone: 01642 624719

Freephone: 0800 092 0084

Opening hours: Monday to Friday, 9:30am to 4:00pm

Email: [email protected]

Out of hours

Out of hours if you wish to speak to a senior member of Trust staff, please contact the hospital switchboard who will bleep the appropriate person.

Telephone: 01642 617617

Data protection and use of patient information

The Trust has developed Data Protection policies in accordance with Data Protection Legislation (UK General Data Protection Regulations and Data Protection Act 2018) and the Freedom of Information Act 2000. All of our staff respect these policies and confidentiality is adhered to at all times. If you require further information on how we process your information please see our Privacy Notices.

Telephone: 01642 383551

Email: [email protected]

Leaflet feedback

This leaflet has been produced in partnership with patients and carers. All patient leaflets are regularly reviewed, and any suggestions you have as to how it may be improved are extremely valuable. Please write to the Clinical Governance team, North Tees and Hartlepool NHS Foundation Trust, University Hospital of North Tees, TS19 8PE or:

Email: [email protected]