Colposcopy & Vulvoscopy procedures

What is a colposcopy?

A colposcopy is the examination of the cervix, vagina or vulva using a colposcope, allowing your healthcare professional to look at any cell changes on the surface of the cervix. This procedure is usually performed if the results of your pap smear are unusual or abnormal, which most often occurs due to human papillomavirus (HPV) infection. HPV can cause abnormal changes to occur on the cervix, and other parts of the pelvic organs, but detection is only possible via a colposcopy on the cervix.

A colposcope is a large, electric microscope that has a bright light on it to enables your doctor to see your cervix more clearly due to being magnified. If any abnormalities are spotted, a sample of tissue will be taken and sent to a lab for examination.

What is a vulvoscopy?

A vulvoscopy involves the examination of the vulva, the surface of the perineum, labia and vaginal opening using a colposcope. This allows your doctor to observe any cell changes on the vulva.

Why is a colposcopy performed?

A colposcopy is usually performed when a pap smear finds abnormal cell changes. Sometimes minor changes in the cells in the cervix return to normal on their own and do not require treatment – in this case your cervix will be monitored by your doctor. Sometimes the changes can become worse and possibly lead to cancer in the future. Abnormal cells do not mean you have cancer, but can be an early sign of changes that could lead to a precancerous state, and later cancer. Early detection is therefore a critical part of cancer prevention strategies.

A colposcopy may be recommended if you have:

  • Bleeding between periods
  • Persistent vaginal discharge
  • Identified abnormalities on the cervix
  • Bleeding after sex
  • If you are a transplant patient
  • If you have HPV

Why is a vulvoscopy performed?

A vulvoscopy might be recommended if you have:

  • Abnormal bleeding
  • Vulval pain during sex
  • Itching or burning
  • Pain or soreness
  • Any visible abnormalities

How are these procedures performed?

A colposcopy is performed in a similar way to a pap smear: a speculum is inserted into the vagina so the doctor can see the opening of the cervix. The cervix is viewed using a colposcope that is used to magnify the area.

If any abnormal cells are detected, a small sample of tissue (biopsy) will be taken and examined under a microscope. If the abnormal cells continue further into the cervix, a cone biopsy may be needed, which is where a larger cone-shaped sample of tissue is taken.

The colposcopy will show whether further treatment is needed or not. If a treatment is required, it will usually be carried out under a local anaesthetic in the clinic, and diagnostic biopsies will be taken at the same time.

It is recommended that a colposcopy not be carried out during your period, as it can make the cervix difficult to see.

A vulvoscopy is performed by using a colposcope to magnify the area, but it is not inserted into the body, so any abnormalities can be seen clearly. If any abnormalities are detected during the examination a small vulvar biopsy will be taken under a local anaesthetic to be examined for any abnormal cells.

A vulvoscopy will be able to show if a treatment is needed or not and if it is required, will be done under a local anaesthetic in the clinic a soon as the biopsy results are available. In some cases, if the affected area is large, or a laser treatment is required, it may be performed under a general anaesthetic as in in-patient in hospital.

What recovery and side-effects should I expect from these investigations?

A colposcopy is a very safe clinical procedure, and the only major risks associated with it include heavy bleeding, and pelvic and abdominal pain. Infection may occur in very rare cases. If you suspect you have an infection, you should consult your treating doctor.

A colposcopy is not recommended for women who are pregnant, as this procedure can lead to complications and early labour.

Some of the side-effects that may be associated with a vulvoscopy include bleeding and infection. It is advised to keep the area dry and clean. If you have any problems, you should consult your treating doctor.

After the procedure, you may experience some pain and bleeding for a few days, but should not have any restrictions to you daily activities, although it is recommended to stay away from strenuous activity. If a biopsy is done, you may experience a small amount of black or brown vaginal discharge. It is recommended to not use vaginal creams or douches, and abstain from sex until the bleeding has stopped.

You should consult your doctor if you have any infectious symptoms such as chills, abdominal pain or cramps, fever or heavy vaginal bleeding.

Your doctor will explain your procedure in detail prior to your appointment, where you will have the opportunity to ask questions.