Colposcopy

After cervical screening (a smear test), you may be invited to a colposcopy appointment. You are usually invited if your result shows human papillomavirus (HPV) and cervical cell changes. 

Colposcopy is where: 

The grade of the cell changes are diagnosed – for example, low-grade or high-grade cell changes may be monitored or treated. This is important because there is a chance of these cell changes developing into cervical cancer without monitoring or treatment. 

What happens during colposcopy? 

You will meet a doctor or nurse called a colposcopist. They will use a type of microscope with a light at the end, called a colposcope, to take a closer look at your cervix. They may offer you tests to help diagnose cell changes and decide whether you need treatment, including: 

• using different liquids to stain your cervix and show up any cell changes 

• a biopsy, where a small piece of cervical tissue is removed – it is then sent to the lab for testing 

If you need treatment, it may be offered during your first colposcopy appointment or you may be invited back to have treatment at another appointment. The option you are offered may be due to what the colposcopy tests show and your colposcopist. Both options are as good as each other. 

If you are offered treatment during your first appointment, it is okay to ask for time to think about it either at the appointment or at home. Your colposcopist should invite you to have a seat away from the examination bed to talk you through the treatment and any questions. 

LLETZ Procedure

LLETZ is a common treatment to remove cervical cell changes. It is usually done in an outpatient clinic in a hospital, using a local anaesthetic. 

After the anaesthetic has worn off, you may experience pain, vaginal bleeding and changes to vaginal discharge. This usually lasts between a few days and 4 weeks. 

The benefit of LLETZ is that it can stop cell changes potentially developing into cervical cancer. It is successful in over 9 in 10 (over 90%) cases, meaning no further treatment is needed. 

Possible risks of LLETZ include an increased risk of late miscarriage or premature birth and cervical stenosis (narrowing of the cervix). 

If you have any physical or emotional effects after LLETZ, it is important to speak with your doctor or nurse so they can give you support. 

LLETZ is the most common treatment for cervical cell changes. It uses a thin wire loop with an electrical current to remove the affected area of the cervix. 

What happens during LLETZ? 

Your appointment will happen in a colposcopy clinic at a hospital. You usually have LLETZ as an outpatient. This means you have it in a hospital examination room, but can go home afterwards. 

You usually have a local anaesthetic for LLETZ. But you can choose to have it done under general anaesthetic, where you are asleep. If you would prefer this, talk to your colposcopist about the risks and benefits before your appointment. 

If you take blood thinning medication or have a condition that affects your blood, it is important to tell your colposcopist before your appointment. You may have a higher risk of bleeding after the treatment.

Once your cervix is numb, your colposcopist uses the loop to remove the area of your cervix that has cell changes. It is normal to notice a slight burning smell and hear a noise like a soft vacuum cleaner. 

The loop cuts the tissue and then another small instrument is used to seal the cut. This should not be painful, but you may feel some pressure. The treatment usually takes less than 2 minutes. 

The cells and tissue that has been removed is sent to a laboratory: 

• The test will check what kind of cell changes you had.

• The test will check whether cell changes have been completely removed. This is done by testing for an ‘edge’ of healthy cells around the area that was removed. This is sometimes called having clear margins.  

What can and can’t I do after LLETZ? 

You may have some physical effects after LLETZ (see page 7). These usually last up to 4 weeks. Until these have stopped, it is best to avoid: 

• tampons or menstrual cups – you can use a period pad instead

• penetrative vaginal sex – including fingers, tongues and other objects

• heavy exercise that causes you to sweat, such as running or a gym workout • swimming

• long baths – you can continue to shower as normal. 

Some travel insurance companies will not provide health insurance straight after treatment, so try to wait for about 4 weeks after treatment before going on holiday or flying. Any effects will usually have stopped by then. If you have a holiday planned, you can discuss dates for treatment with your colposcopist. 

If you have any questions about what you can and can’t do after LLETZ, speak with your colposcopist. 

Follow-up after LLETZ 

After LLETZ, you will be invited for a follow-up appointment at your GP surgery or the colposcopy clinic. This should happen 6 months after the treatment. 

At this follow-up appointment, you will have a test of cure. This is like cervical screening, where a sample of cervical cells is tested for high-risk HPV. 

Hope you found this information helpful.