Abnormal Cervical Screening Tests, Colposcopy and Biopsy

Screening for cervical cancer (cervical screening test – CST)

This is an important part of staying healthy and avoiding cervical cancer. If the results of your screening tests are abnormal further testing is needed to confirm the result and determine the severity of the abnormality. Colposcopy is the test that is usually recommended in this case. It allows Dr Len Kliman to look at your cervix using a digital microscope. Biopsies may also be taken at the time of the colposcopy.

Not all women with abnormal cervical screening tests will need treatment. Colposcopy with or without biopsy can help determine if and when treatment of the abnormality is needed. Often follow up is all that is required.

Why do I need a colposcopy?

Colposcopy is used to follow up abnormal cervical screening tests or abnormal areas seen on the cervix, vagina or vulva. Abnormal CST’s or cervical screening tests are due to infection with the HPV or human papilloma virus. Colposcopy may also be necessary for abnormal symptoms, especially bleeding after intercourse. In this case it may be deemed that a colposcopy is necessary even if your cervical screening test has been normal.

The colposcope, or digital microscope, magnifies the appearance of the cervix. Acetic acid, or vinegar, is often placed on the cervix and vagina to stain any abnormal cells and allow Dr Kliman to better see where the abnormal areas are located and where a biopsy may be necessary. Pre-cancerous areas, if diagnosed and treated appropriately, rarely develop into cervical cancer.

Preparing For colposcopy

Before your colposcopy appointment you should not put anything in the vagina, for example vaginal creams. Colposcopy can be done during most times of your cycle but if you are having heavy menstrual bleeding on the day of your appointment you should reschedule by phoning the office.

If you know or think you could be pregnant let us know. Colposcopy is safe during pregnancy, although we avoid performing biopsies on pregnant patients.

Colposcopy procedure

The colposcopy is performed on a comfortable examination chair and one of our experienced registered nurses is always present during the procedure to assist Dr Kliman and provide support for our patients. The instrument used to perform a cervical screening test, a speculum, is used to open the vagina and visualise the cervix. Dr Kliman may repeat your cervical screening test and then will look at your cervix using the colposcope which is built in to the examination chair. Dr Kliman may apply acetic acid to your cervix and vagina to highlight the abnormal areas. You may feel some slight burning or stinging from the vinegar and if this is worrying for you, Dr Kliman will wash out the vinegar at the conclusion of the procedure using sterile saline.

If an abnormal area is seen it may be necessary to take a biopsy to be certain as to the diagnosis. A local anaesthetic is rarely needed as the procedure is associated with minimal discomfort. The tissue sample will be sent to the Victorian Cytology Service for analysis. Similarly any cervical screening tests are also sent to the Victorian Cytology Service for analysis.

If you have a biopsy Dr Kliman may apply a yellow/brown solution to your cervix which helps to prevent any bleeding and acts as an antiseptic. This solution is called Monsel’s paste.

Following the colposcopy

If you have a biopsy of your cervix you may have some light vaginal bleeding. If Dr Kliman has used the Monsel’s paste you may have a brown vaginal discharge which should resolve within a few days.

Most women are able to return to work the same day after the procedure and there can be some minimal discomfort which lasts for one to two hours.

Do not use any vaginal creams or tampons for 48 hours and avoid intercourse for 48 hours.

If you have had a biopsy or cervical screening test the result is usually available within seven working days and any further testing or treatment will depend on the result of this cervical screening test or biopsy.

We will notify you of the results even if they are normal.

When to contact us after a colposcopy?

Contact the office, or if after hours, contact Dr Kliman via the paging service if you have heavy vaginal bleeding, vaginal bleeding that lasts for more than seven days, an offensive vaginal discharge, significant pelvic pain or cramps that don’t resolve with simple pain killers such as paracetamol or naproxen (anti prostoglandin agent), or a temperature of 38 degrees Celsius or more.