LLETZ Procedure or Colposcopy

What is Colposcopy?

Colposcopy is a procedure in which a special magnifying instrument called a colposcope is used to look into the vagina and into the cervix. The colposcope gives an enlarged view of the outer portion of the cervix. 

This procedure is used for the removal of small segments of the cervix (the lower part of your womb or uterus)

Why would a Colposcopy be necessary?

Colposcopy is done when there are abnormal changes in the cells of the cervix as seen on a Pap test. Further, it may be done to assess problems such as genital warts on the cervix, inflammation of the cervix, benign growths or polyps, pain and bleeding.

How is the Colposcopy procedure done?

During a colposcopy, you will lie on your back with feet raised just as you do when you have a regular pelvic examination. A colposcopy takes 4 minutes to perform. Dr Cook uses an instrument called a speculum to hold the walls of the vagina apart. Then the colposcope is placed at the opening of your vagina.

A mild solution may be applied to the vagina and cervix with a cotton swab. This allows abnormal areas to be seen easily.  Dr Cook will look inside the vagina and cervix to locate any problems. If there are any abnormalities, Dr Cook may take a small tissue sample called a biopsy.

You may feel a mild pinch or cramp while the biopsy sample is taken. The tissue is then sent to a laboratory for further study.

What to expect after the Colposcopy procedure?

Dr Cook will talk to you about any problems detected during colposcopy. If a sample of tissue was taken from your cervix (biopsy), the laboratory results should be ready in 2 weeks.

Most women feel fine after colposcopy. You may feel a little lightheaded and if you have had a biopsy, you may have some mild bleeding. Talk to Dr Cook about how to take care of yourself after the procedure and when you need to return for a check-up.

What are the risks of colposcopy?

There may be a risk of infection when you have a colposcopy. Mild pain and cramping during the procedure and mild bleeding afterwards are common. This most often happens when a biopsy is done. If there is heavy bleeding, fever, or severe pain after the procedure, contact Dr Cook immediately.

How is an abnormal Pap smear treated?

If the results of the colposcopy reveal a high grade abnormality (CIN II or III) then a LLETZ (Large Loop Excision of the Transformation Zone) is performed. Dr Cook will perform this as a Day Stay procedure. It involves removing the abnormal cells from the tip of the cervix.

A cone biopsy is performed depending on the type and depth of the lesion.

This specimen is sent for histopathological examination. Complications are uncommon and include infection and bleeding. Most women will experience brown vaginal loss for about three weeks. It is advised that you avoid swimming, intercourse, baths and the use of tampons for this time to minimise the risk of infection.

Abnormal Pap smear during pregnancy

A Pap smear during pregnancy is very safe. In case of an abnormal Pap smear, a colposcopy can be performed during pregnancy. However, further treatments are delayed until the birth of the baby.