Colposcopy London - Gynaecology

Medically Reviewed April 2023, by Mr. Bryan Mayou (GMC: 1414396) - founder of the Cadogan Clinic and one of the world's leading plastic surgeons

What is a Colposcopy?

A colposcopy is a diagnostic procedure designed to examine the cervix, the opening to the womb from the vagina.

In a colposcopy procedure, a microscope is used to have a closer look at the cervix. You may be offered a colposcopy after a smear test, but the procedure can also be used to find out the cause of other symptoms, for example, vaginal bleeding following sexual intercourse. A colposcopy biopsy, where a sample of tissue is taken for further testing, may follow the procedure.

The colposcopy procedure is very quick, taking just 15 to 20 minutes from start to finish. An anaesthetic is not usually necessary as the procedure doesn’t hurt, although some women may experience mild discomfort.

A colposcopy procedure may feel a little bit daunting, but it is a highly effective diagnostic tool used to identify illnesses such as cancer. Most of the time, a colposcopy will find nothing of concern. But if you do feel anxious about your colposcopy, speak to one of our expert medical team who will help to put your mind at rest.

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"At the beginning before the operation the nurse taking care of me made me feel so comfortable. The surgeon and anesthetist helped me feel so calm. Fantastic before and after treatment"

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When is a colposcopy necessary?

A colposcopy procedure is sometimes carried out after a cervical smear test. A cervical smear is a routine test which can identify abnormal cells on the cervix. But a colposcopy can also be used to investigate other health issues involving the cervix. Here we will look at the main reasons when a colposcopy is necessary.

Abnormal smears

If your cervical screening, or smear test, detects the presence of abnormal cells, then further investigation is required. Although these abnormal cells are not cancer, there is a risk that these may turn into cervical cancer if they are not treated promptly.

You may also be offered a colposcopy if the results of your smear test showed changes to the cervical cells or if it had not been possible to obtain clear results, despite several attempts at a smear test.

HPV

The human papillomavirus (HPV) is the name for a very common group of viruses. There are more than one hundred different types of HPV and most are not cause for concern. However some of these viruses may cause cancer or other gynaecological problems, such as genital warts. If you have been infected with HPV, then you will need to have a colposcopy.

Cervical health

A colposcopy is not only used to detect the presence of abnormal, precancerous or cancerous cells. A colposcopy procedure may be used to investigate other gynaecological health concerns. These include:

Benign growths: Non-cancerous growths include polyps and cysts.
Cervicitis: Cervicitis is an inflammation of the cervix. Common symptoms include bleeding inbetween periods, pain during sex or during a pelvic exam and abnormal vaginal discharge. Some people with cervicitis may not experience any symptoms. Cervicitis may be caused by a sexually transmitted infection, such as chlamydia or gonorrhea, but it can also occur due to noninfectious causes.
Genital warts: Genital warts are a common sexually transmitted infection, caused by HPV. They can appear on the vulva, vagina and anus, but in some cases warts may also appear on the cervix. As a result, these are harder to spot. Genital warts are easily treated. The type of HPV that causes genital warts is called low-risk HPV, which is not linked to cancer. If you have genital warts, this does not increase your risk of cervical cancer.
Unexplained bleeding or pain: If you are experiencing unexplained vaginal bleeding or pain, then this is something that requires further investigation. This includes unexpected vaginal bleeding after sexual intercourse.
Abnormal appearance of the cervix: If the doctor or nurse who carried out your smear test thinks your cervix doesn’t look as it should, then they may refer you for a colposcopy for further investigation.

Who is suitable for a colposcopy?

You are suitable for a colposcopy if one or more of the following are true:

Abnormal cells were found during your smear test
It has not been possible to obtain a result from several smear tests
You have been infected with HPV
There are concerns about the appearance of your cervix (ie changes in its appearance)
You are experiencing unexplained vaginal bleeding (ie after sex or between periods)
You have growths on your cervix (which may be benign)
You have unexplained pelvic pain

You can still have a colposcopy if you are pregnant. A colposcopy procedure will not harm your baby. You may need to rearrange your colposcopy if you are on your period or if you are due that day. Please let us know in advance if this is the case.

The cost of Colposcopy

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How does the procedure work?

You will be asked to undress from the waist down and lay on a couch with your knees bent.

A smooth device called a speculum will be carefully inserted into your vagina to hold it open. This is the same type of device that will have been used during your cervical screening (smear) test.

An instrument called a colposcope, which looks like a pair of binoculars, will be used to examine the cells on your cervix. The colposcope does not touch you and is not inserted into your vagina, but stays around 12 inches outside of the body and the cells are displayed on a screen.

The person carrying out your colposcopy procedure may then put different liquids onto your cervix in order to make any abnormal cells more visible. If abnormal cells are found, a tissue sample measuring no more than a few millimetres across will be taken from the cervix. This is known as a biopsy. This sample will then undergo laboratory testing. Depending on what is discovered, treatment may be recommended straight away.

You may experience a small amount of vaginal discharge or bleeding following your colposcopy, so you may wish to bring a pantyliner with you to your appointment.

You should not have sex or use any creams, lubrications or medications on your vagina, or use tampons, for at least 24 hours before your colposcopy procedure.

What happens after a colposcopy?

The colposcopist is usually able to tell you the results of your colposcopy procedure straightaway. If there is any doubt, a biopsy will be taken for laboratory tests. The results may take up to four weeks.

Around four out of 10 women who have a colposcopy have a normal result, meaning the cervix is healthy and they are at a low risk of developing cervical cancer before their next smear test. Six out of 10 women who have a colposcopy procedure have abnormal cells in their cervix. The most common type is cervical intraepithelial neoplasia (CIN). Cell abnormalities found in the glandular cells inside the lining of the birth canal of the cervix are known as intraepithelial neoplasia (CGIN). This is less common than CIN.

Although CIN and CGIN are not cancer, they can sometimes develop into cancer if not treated promptly.

CIN is graded from one to three according to its severity, with three being at the highest risk of developing into cervical cancer. CGIN is classed as either low-grade or high-grade.

CIN 1 cells will normally disappear on their own and no treatment is required. You will be invited for a follow-up smear test in 12 months. CIN 2, CIN 3 and CGIN abnormal cells will be removed to lower the risk of these cells developing into cancer.

The most common method of removing these cells is by large loop excision of the transformation zone (LLETZ). This procedure uses a thin wire loop that's heated with an electric current to remove the affected cells. It takes around five to 10 minutes and you can go home on the same day as the procedure. Local anaesthetic is used to numb the area, although you may experience some mild pain or cramping after LLETZ.

The procedure may take longer if a larger area of the cervix needs to be treated and a general anaesthetic may be used. Alternatively, a cone biopsy may be carried out if a larger area is being treated. This involves removing a large cone-shaped piece of tissue via laser or scalpel. This is carried out under a general anaesthetic.

Other treatments include cryotherapy (freezing and destroying abnormal cells), laser treatment (a laser is used to pinpoint and destroy abnormal cells), cold coagulation (abnormal cells are burned away) and a total hysterectomy (only considered if abnormal cells have been detected more than once or if cells are severely abnormal).

Very occasionally, the colposcopy and biopsy will detect cervical cancer. If this is the case, you will be referred to a team of specialists and cancer treatment will begin as soon as possible.

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Mr. Yasser Diab

Gynaecologist and Obstetrician

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Frequently Asked Questions

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Does a colposcopy mean I have cancer?

No, having a colposcopy does not mean that you have cancer. It is a diagnostic procedure which allows for closer inspection of abnormal cells. These cells may or may not indicate cancer. It is worth remembering that a colposcopy is often used to rule out the presence of cancer. It is rare to find cervical cancer during a colposcopy procedure. If you have any concerns, you should talk to your doctor who will do their best to set your mind at rest.

How painful is a colposcopy?

A colposcopy procedure is not painful, although it is common to feel some discomfort when the speculum is inserted into the vagina. You may also experience a mild stinging or tingling when the doctor puts liquid on your cervix to help show up any abnormal cells that might be present. During a colposcopy biopsy, a small tissue sample is removed for testing, which may result in a scratching or mild pinching sensation. If you do experience any pain, it may be possible to apply a local anaesthetic.

For a few days after a colposcopy you may experience some mild pain, which may feel like period pain. Simple over-the-counter painkillers can help with this.

How long does it take to recover from a colposcopy?

A colposcopy procedure is quick and there is no downtime attached. The procedure is over in just 15 to 20 minutes and then you may leave the clinic. You may feel like resting at home, but you may feel well enough to return to work or continue with your other day-to-day activities.

You may feel some mild cramping, similar to period pain, around the lower abdomen following your colposcopy. You are likely to have some bleeding and discharge coming from the vagina after the procedure. This should only last for a few days.

What is a cervical biopsy?

In a cervical biopsy, the doctor will take a sample of tissue from the cervix to test for abnormal cells, precancerous conditions or cervical cancer.

There are different types of biopsy, including a punch biopsy (a circular blade similar to a hole puncher is used to remove the tissue), a cone biopsy (a laser or scalpel is used to remove large cone-shaped piece of tissue) and endocervical curettage (a narrow instrument called a curette is used to scrape the lining of the endocervical canal).

How much does a private colposcopy cost?

Private colposcopy costs in the UK start from around £650. The final cost depends on what is included in the diagnostics package and whether any treatment is included.

If you choose the Cadogan Clinic for your private colposcopy in London, you will get:

Up to two 60 minute consultations with a leading specialist plastic surgeon at our award-winning premises in Chelsea
Your colposcopy procedure at London’s leading specialist cosmetic surgery centre of excellence#
24/7 on-call nurse assistance
A Dedicated Patient Coordinator, as a personal point of contact through your journey with Cadogan
A preoperative medical assessment
Comprehensive aftercare courtesy of our specialist team of nurses

Can I get a colposcopy on the NHS?

Yes, you can get a colposcopy on the NHS. However the NHS has been, and continues to be, hit hard by the Covid-19 pandemic. High levels of staff sickness have had an impact on waiting times across the board. These waiting times vary from hospital to hospital. And any new waves of Covid-19 infections may result in this wait getting even longer. Because of this, many people choose to go to a private clinic for their colposcopy. At the Cadogan Clinic, there is no waiting list, so you can have the procedure promptly.

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Colposcopy