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Colposcopy

Colposcopy is a procedure that is performed in order to investigate patients who have an abnormal smear so as to decide if treatment is needed. When a woman has a smear report describing an abnormality, she may be advised to have her smear test repeated within 6 months. She may also be required, if necessary, to have a colposcopy examination in a nationally accredited colposcopy unit.

The colposcopy service in the hospital operates in association with The National Cancer Screening Service and CervicalCheck.

The Coombe colposcopy service has moved into a new purpose-built unit that is located at the back of the hospital. There are plenty of signs at the main entrance, and in the car park, that will guide you to where we are.

Colposcopy examination

When a cervical smear is reported as abnormal, or if an abnormality persists, referral for colposcopy will be advised.

Colposcopy allows the colposcopist (a gynaecologist, or a nurse colposcopist) to examine a very small piece of skin covering the cervix, at the opening to the cervical canal leading to the inside of the womb. This small area is called the transformation zone or TZ.

The colposcopy examination involves looking at the cervix with a microscope called a Colposcope held just outside the vagina. It involves the woman having to lie on a couch with a speculum placed in the vagina (a speculum is the instrument that is used to help with taking a smear). Whilst the procedure may feel a little undignified and embarrassing for some women, and may be a bit uncomfortable, it is not a painful investigation. It usually takes about 5 minutes.

As part of the examination the colposcopist may decide to repeat your smear test. Following this, a solution is sprayed onto the cervix that will make any changes in the cells on the cervix visible to inspection. Sometimes this is followed by the application of an iodine solution to help further with the assessment of the area. Some women report a slight tingling sensation due to the solutions used during this part of the examination, but it is not painful.

If changes are seen, the colposcopist may decide to take a small biopsy from the cervix as confirmation. This biopsy along with the smear test will be sent to the hospital laboratory for assessment and a report is usually issued within 3-4 weeks. We may then arrange a follow-up appointment as appropriate with the test results.


Colposcopy and treatment

During the colposcopy examination, the colposcopist may decide that the degree of change seen on your cervix warrants treatment. This is commonly known as a  LLETZ (Large Loop Excision of the Transformation Zone) procedure. LLETZ treatment can be performed on the same day as the first examination. It is performed using local anaesthetic.

Occasionally, a decision will be made to perform LLETZ under general anaesthesia in theatre as a day-case procedure. If so, you will be advised on the day of your visit and arrangements will be made to bring you into the day ward at a later date.

Following treatment, the majority of patients will never have another abnormal smear. Everyone attending the clinic (whether treated or not) needs to be followed up for a period of time. After this, most patients may return to just having cervical smear tests with their GP.

Post treatment advice

Some patients may wish to be accompanied to the clinic if they are travelling long distances, especially if they are having a treatment performed.

The cervix or neck of the womb can take up to 4 weeks to heal after treatment by LLETZ. Often there will be a little bleeding to begin with. This bleeding should be less than a normal period. It may be followed by a brown discharge that can continue for up to 4 weeks. During this time it is advisable to avoid sex or the use of tampons, swimming pools and Jacuzzis in order to reduce the risk of infection. Five in every 100 women treated by LLETZ may develop a vaginal infection. Common signs of infection are fever, tummy pain and smelly discharge. If you experience these symptoms, antibiotic treatment may be necessary and you can contact us for advice.

The Coombe Colposcopy service runs clinics 5 days every week. To phone for information telephone 01 408 5759 or 01 4085726.

Coombe Women & Infants University Hospital
Cork St.
Dublin 8.

Tel: +353-1-408 5200
Fax: +353-1-453 6033
email: info@coombe.ie

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