Colposcopy and LEEP/LLETZ

  1. What is colposcopy?

Colposcopy is a way of looking at the cervix through a special magnifying device called a colposcope . It shines a light into the vagina and onto the cervix. A colposcope can greatly enlarge the normal view. This exam allows an obstetrician– gynaecologist (OBGYN) to diagnose and treat problems that cannot be seen by the eye alone.

 

  1. Why is colposcopy done?

Colposcopy is done when results of cervical cancer screening tests show abnormal changes in the cells of the cervix. Colposcopy provides more information about the abnormal cells. Colposcopy also may be used to further assess other problems, including

  • genital warts on the cervix
  • cervicitis (an infIamed cervix)
  • benign (not cancer) growths, such as polyps
  • pain
  • bleeding

Sometimes colposcopy may need to be done more than once. It also can be used to check the result of a treatment.

  1. How is the procedure performed?

Colposcopy is typically is done in theatre.

The procedure is best done when a woman is not having her period. This gives the OBGYN a better view of the cervix.

For at least 24 hours before the test, you should not

  • douche
  • use tampons
  • use vaginal medications
  • have sex

As with a pelvic exam , you will lie on your back with your feet raised and placed on foot rests for support. A

speculum will be used to hold apart the vaginal walls so that the inside of the vagina and the cervix can be seen.

The colposcope is placed just outside the opening of your vagina.

A mild solution will be applied to your cervix and vagina with a cotton swab or cotton ball. This liquid makes abnormal areas on the cervix easier to see.

 

  1. When is a biopsy done during colposcopy?

During colposcopy, your ob-gyn may see abnormal areas. A biopsy of these areas may be done. During a biopsy, a small piece of tissue is removed from the cervix. The sample is removed with a special device.

Cells also may be taken from the canal of the cervix. A special device is used to collect the cells. This is called endocervical curettage.

 

  1. What should I expect during recovery?

If you have a colposcopy without a biopsy, you should feel fine right away. You can do the things you normally do. You may have a little spotting for a couple of days.

If you have a colposcopy with a biopsy, you may have pain and discomfort for 1 or 2 days. Over- the-counter pain medications can be helpful. You may have some vaginal bleeding. You also may have a dark discharge for a few days.

This may occur from medication used to help stop bleeding at the biopsy site. You may need to wear a sanitary pad until the discharge stops.

Your ob-gyn may suggest you limit your activity for a brief time. While the cervix heals, you will be told not to put anything into your vagina for a short time. Follow these guidelines:

  • Do not have sex.
  • Do not use tampons.
  • Do not douche.

 

  1. When should I call my ob-gyn?

Call your ob-gyn right away if you have any of these problems:

  • Heavy vaginal bleeding (using more than one sanitary pad per hour)
  • Severe lower abdominal pain
  • Fever
  • Chills

 

  1. What is a loop electrosurgical excision procedure (LEEP) and why is it done?

If you have an abnormal cervical cancer screening result, your health care professional may suggest that you have a loop electrosurgical excision procedure (LEEP) as part of the evaluation or for treatment.

LEEP is one way to remove abnormal cells from the cervix by using a thin wire loop that acts like a scalpel (surgical knife). An electric current is passed through the loop, which cuts away a thin layer of the cervix.

 

  1. How is LEEP performed?

A LEEP should be done when you are not having your menstrual period to give a better view of the cervix. In most cases, LEEP is done in a surgical theatre. The procedure only takes a few minutes.

During the procedure you will lie on your back and place your legs in stirrups. The health care professional then will insert a speculum into your vagina in the same way as for a pelvic exam.

General anaesthesia will be used to prevent pain. It is given through a needle attached to a syringe. The loop is inserted into the vagina to the cervix. There are different sizes and shapes of loops that can be used.

After the procedure, electrocautery may be applied to your cervix to stop any bleeding.

The tissue that is removed will be studied in a lab to confirm the diagnosis.

  1. What are the risks of LEEP?

The most common risk in the first 3 weeks after a LEEP is heavy bleeding. If you have heavy bleeding, contact your health care professional. You may need to have more of the paste applied to the cervix to stop it.

LEEP has been associated with an increased risk of future pregnancy problems. Although most women have no problems, there is a small increase in the risk of premature births and having a low birth weight baby. In rare cases, the cervix is narrowed after the procedure. This narrowing may cause problems with menstruation.

 

  1. What should I expect during recovery from LEEP?

After the procedure, you may have:

  • A watery, pinkish discharge
  • Mild cramping
  • A brownish-black discharge (from the paste used)

It will take a few weeks for your cervix to heal. While your cervix heals, you should not place anything in the vagina, such as tampons or douches. You should not have intercourse. Your health care professional will tell you when it is safe to do so.

  1. You should contact your health care professional if you have any of the following problems:
  • Heavy bleeding (more than your normal period)
  • Bleeding with clots
  • Severe abdominal pain

Will I need follow-up visits?

After the procedure, you will need to see your health care professional for follow-up visits. You will have cervical cancer screening to be sure that all of the abnormal cells are gone and that they have not returned. If you have another abnormal screening test result, you may need more treatment.

You can help protect the health of your cervix by following these guidelines:

  • Have regular pelvic exams and cervical cancer screening.
  • Stop smoking— smoking increases your risk of cancer of the cervix.
  • Limit your number of sexual partners and use condoms to reduce your risk of sexually transmitted infections (STIs) .
× How can we help you?