Abnormal Pap Smears

Colposcopy – Abnormal Pap Smears

Colposcopy is performed by gynaecologists for women with abnormal Pap smear results. The Renewed Cervical Cancer Screening Program was implemented in Australia in December 2017.  This new program is based primarily on testing for the Human Papilloma Virus (HPV), but colposcopy is still a fundamental part of the Cervical Screening Program for women who test positive for HPV and have an abnormal cervical Smear.  Women with abnormal bleeding, such as bleeding after sexual intercourse (post-coital bleeding), will also require a colposcopy for close examination of their cervix, even if the HPV test or the cervical smear is normal.

The colposcope is essentially a microscope that provides a magnified view of the cervix (the neck of the womb), like a set of binoculars on a stand.

Colposcopy allows your Gynaecologist to assess the severity or grade of the abnormality on the cervix, and to determine the extent of the abnormality on your cervix.  Your GP may recommend that you have a colposcopy if:

  • Your Pap smear shows an abnormality
  • You have bleeding after sexual intercourse
  • The appearance of your cervix looks abnormal
  • You have persistent vaginal discharge

Just because your GP has referred you for a colposcopy, it does NOT mean you have cervical cancer.

The Cervix is the neck of the uterus (womb)

What is a Colposcopy?

Colposcopy involves using a microscope to look at the cervix in detail under magnification.  The colposcope does not go into the vagina, and does not even touch your body.  Vinegar (very mild Acetic acid) is applied to the cervix, which highlights areas with abnormal cells.  When this solution is applied to your cervix, it may feel a little cold, but it does not hurt or cause pain.  A tiny piece of tissue (biopsy) may be sent to the laboratory for further analysis.  There will be a small amount of spotting after the biopsy, and Brisbane Colposcopy specialist Dr Ken Law will apply a yellow paste to the area, which acts like a bandage to stop any bleeding.  After the biopsy, you may feel some cramping or discomfort, but this only lasts a short period of time, and if necessary, simple pain killers like Paracetamol or Ibuprofen are very effective.

How long does a Colposcopy take?

A colposcopy takes slightly longer than a routine Pap smear examination.  Similar to a Pap smear examination, a speculum is inserted into the vagina, which allows the cervix to be visualised.  The colposcope is then used to look at the cervix.  Overall, colposcopy takes 5-10 minutes to perform, and can be done in Brisbane Colposcopy Specialist Dr Ken Law’s rooms as part of your consultation.

When do I find out my Colposcopy results?

As soon as Dr Ken Law has finished the colposcopy procedure, he will be able to tell you his overall assessment of the colposcopic appearance of your cervix, and make a preliminary diagnosis.  The cervical biopsy result will usually take 2-3 days, and this will confirm and establish the final diagnosis.

Preparing for your Colposcopy

You should not put anything in your vagina for 24 hours before your colposcopy appointment with your colposcopy specialist.  This means no sexual intercourse, no douches, no thrush treatments, and no spermicides.

Can I have my Colposcopy performed during my menstrual period?

In order to allow the best view of the cervix, it may be necessary to postpone your colposcopy examination until your period has finished, or at least until the menstrual flow has slowed down.  If you have heavy vaginal bleeding on the day you are scheduled for your colposcopy, please contact Dr Ken Law’s receptionists to reschedule your colposcopy to another day.

Can I have my Colposcopy if I am pregnant?

Colposcopy is safe during pregnancy, and if high grade Pap smear abnormalities are detected during pregnancy, it is important to have a colposcopy performed during the pregnancy.  As the cervix has a very rich supply especially during pregnancy, a biopsy is usually not performed during pregnancy.

Gynaecologist is a specialist in Brisbane with expertise and a special interest in Colposcopy, and is accredited by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) to perform Colposcopy for diagnosis and treatment of pre-cancerous abnormalities (“Cervical Intra-epithelial Neoplasia; CIN 1-3).
If pre-cancerous abnormalities are confirmed on Colposcopy, Dr Ken Law has extensive experience in curative treatment procedures such as a LLETZ procedure (Large Loop Excision of the Transformation Zone, also known as LEEP in the UK) and Cone Biopsy.  These treatment procedures are performed as day surgery procedures, under general anaesthetic or local anaesthetic.

Dr Ken Law is a certified colposcopist of the RANZCOG Colposcopy Quality Improvement Program (C-QuIP), and is a member of the Australian Society for Colposcopy and Cervical Pathology (ASCCP).  He has extensive experience in the management of abnormal Pap smears, and has an excellent track record of accurate diagnosis and complete treatment.  Quality of care is assured by his active participation in the RANZCOG C-QuIP audit program for certified colposcopists.

If cervical cancer is diagnosed, Dr Ken Law works closely with Dr Amy Tang, a certified gynaecological oncologist who specialises in the management of gynaecological malignancies such as cervical cancer.  This ensures that women receive prompt diagnosis and treatment for both pre-cancerous and cancerous disease of the cervix.