If a colposcopy finds abnormal cells in your cervix, you'll be advised to have treatment to remove the abnormal cells.
Removing these cells means they will not be able to turn into cancer. An area about the size of a fingertip is normally removed.
If you do not have treatment, sometimes there's a risk that these cells could become cancerous.
When treatment is carried out
During your coloscopy it may be obvious to the doctor or nurse that you have abnormal cells. If it is, treatment to remove the cells can sometimes be done at the same time. This normally takes 5 or 10 minutes.
If it is not obvious that you have abnormal cells, you may have a biopsy. This is to help decide if you need treatment. Any treatment you may need will have to wait until after you get your biopsy result.
Types of treatment
There are several ways abnormal cells can be removed from the cervix.
The most common type of treatment is LLETZ (large loop excision of the transformation zone).
It involves removing the abnormal cells using a thin wire loop. This is heated with an electric current.
A LLETZ can be carried out at the same time as a colposcopy.
It does not usually need an overnight stay in hospital. It is normally done while you're awake. Local anaesthetic is injected into your cervix to numb it during the treatment. This means that you won't feel pain.
You may notice a burning smell during this procedure. This is normal. The tissue sample is sent to the lab for assessment.
If you become pregnant, it is important to tell your GP or doctor that you have had a LLETZ. This is because there may be a small risk to future pregnancies.
LLETZ is also called loop diathermy, loop cone, loop biopsy or loop excision.
Cold coagulation involves applying a heat source to the cervix. This burns away the abnormal cells.
It is normally done while you're awake. Local anaesthetic is injected into your cervix to numb it during the treatment. This means that you won't feel pain.
You may feel period-like pain during this treatment. The pain may last for a short time afterwards. A tissue sample is not taken.
You may notice a burning smell during this procedure. This is normal.
A cone biopsy is a minor operation to cut out a cone-shaped piece of tissue containing the abnormal cells. It is usually only used if a large area of tissue needs to be removed.
It cannot be done at the same time as a colposcopy. It is done under general anaesthetic (where you're asleep). You may need an overnight stay in hospital.
If you become pregnant, it is important to tell your GP or doctor that you have had a cone biopsy. This is because there may be a small risk to future pregnancies.
You can often go home soon after the treatment. Most people feel well enough to return to work and carry out normal activities the next day.
It takes 4 to 6 weeks for your cervix to heal after treatment.
To reduce the risk of infection do not:
- use tampons for 4 to 6 weeks - use sanitary pads instead
- have sex for 4 to 6 weeks
- swim or use a Jacuzzi for 4 to 6 weeks
- exercise for at least a few days, or while there's still any bleeding or discharge. This includes light exercise, such as golf
- do heavy work or heavy house work such as vacuuming
- take a bath for 6 weeks - have a shower instead
9 out of 10 women who have had a treatment at colposcopy will not need another treatment.
Results of your treatment
You will get a letter with the results of your treatment in about 6 weeks.
Your results letter will include:
- the grade of abnormal cells that was diagnosed in the lab
- your next recommended step
In most cases, the next step is a follow-up appointment at the clinic in 6 months.
Follow-up screening test
You may need another cervical screening test within a year of treatment. This is to check for HPV infection and abnormal cells.
Once your follow-up test is clear of HPV and abnormal cells, you will return to have your regular screening test. This will be every 3 years, regardless of your age.
Risks and side effects
Common side effects of treatment include:
- mild pain, like period pain - this should pass in a few hours, you can take paracetamol or ibuprofen for the pain
- light vaginal bleeding and brown, watery vaginal discharge - this may last for 4 to 6 weeks
- heavier than usual first period after treatment - your periods will return to normal
There's a small risk of more serious complications, such as:
- an infection
- a slightly increased risk of premature birth (before the 37th week of pregnancy) in future pregnancies
An infection can cause heavy or persistent bleeding or smelly vaginal discharge. It can also cause a fever or constant tummy pain.
Immediate action required: Contact the colposcopy clinic or your GP if you have:
- heavy or persistent bleeding
- smelly vaginal discharge
- a fever
- constant tummy pain
In most cases, the benefit of treatment will outweigh these risks.
Talk to your GP or nurse if you have any concerns. They can tell you more about the potential risks of treatment.
Risks to future pregnancy
Treatment for abnormal cervical cells will not affect your chances of getting pregnant.
There is a small risk that you may be at increased risk of a miscarriage or give birth prematurely.
An increased risk of premature birth is more likely if:
- you need repeated treatments
- a lot of tissue needs to be removed
But the benefits of early treatment and prevention of cervical cancer far outweigh this risk.
Tell your doctor or obstetrician (a doctor who delivers babies) about your treatment at the colposcopy clinic if you:
- have had multiple treatments
- are pregnant
- are considering a pregnancy
- have had a cone biopsy
Removing tissue around the cervix
The more tissue that needs to be removed, the less you will have to support future pregnancies.
Your doctor will try to remove as little tissue as possible. But they need to make sure the treatment is successful.
Talk to your doctor or nurse about any concerns you have.
Content supplied by the NHS and adapted for Ireland by the HSE