Firstly – DON’T PANIC!
An abnormal pap smear does not necessarily mean cancer. There are many reasons why smears return a ‘Positive’ or Abnormal result including many low-grade infections or technical problems with the smear itself. Your smear result and the plan for diagnosis, treatment (if required) and follow up will be clearly discussed throughout your visit along with clear documentation of your visit back to your referring doctor.
What is Colposcopy?
Colposcopy is a simple procedure performed at the time of your visit if required and is designed to give you immediate answers to your concerns. It involves a similar process to taking a pap smear with the additional use of a high-definition magnifying device known as the Colposcope, which enables a very clear magnified view of the cervix.
A dilute solution of acetic acid (vinegar) is sprayed onto the cervix during this examination to help clarify the abnormal cells better. A small biopsy may be required at this time with a specialised device, which takes a split second to perform usually with minimal discomfort. Results are then reviewed usually within 24-48 hours and discussed either in person or over the phone.
When do I need Colposcopy?
Generally most times colposcopy is required as a direct result of an abnormal pap smear, which is a screening test for precancers of the cervix generally associated with HPV (Human Papilloma Virus) infections. The majority of these HPV infections are completely asymptomatic. Colposcopy is also frequently necessary to investigate a history of post coital bleeding (bleeding after intercourse) or any unusual vaginal discharge or unusual appearance or consistency of the cervix noted by whomever performed the original pap smear.
What if I need treatment?
Should treatment be required this is most often done as a day surgical procedure either under local or general anaesthetic. This is known as a LLETZ procedure. A larger treatment specimen called a CONE biopsy may sometimes be necessary also as a day surgical procedure depending on size and position and severity of the lesion being treated.
Is treatment effective?
Treatment for premalignant conditions of the cervix is usually extremely effective in curing the condition as a once off procedure and rarely interferes with future fertility and delivery. This will be discussed in detail if you require treatment.
What follow up do I need?
This will be discussed with you on the basis of your individual circumstances but generally current recommendations after successful treatment require a colposcopy at 6 months post treatment (no biopsy required unless an abnormality is detected) after which most patient will have a further pap smear and HPV swab in a further 6 months with their GP. If this is all OK further smears are not required for another 12 months. A follow up plan will be clearly outlined and documented for you. Some conditions such as Adenocarcinoma-in-situ ACIS require ongoing regular colposcopic surveillance for follow up.