Colposcopy
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We specialise in abnormal pap smear/cervical screening test management and provide an urgent colposcopy service.

Women with HPV 16/18 or a possible high grade abnormality of the cervix will usually be seen by Dr Aubrey within a few weeks of referral. Treatment can be arranged if necessary, and women without private health insurance can be referred on for treatment as a public patient if required.

Few of our patients have heard of colposcopy before they are referred for this procedure, and many have questions about what to expect. While many feel anxious, occasionally women attend with a misplaced notion that an abnormal cervical screening test means they have cancer. In the vast majority of women, this is not the case. However, it is important to attend for colposcopy when referred, because abnormalities of the cervix can be detected, monitored and/or treated to avoid cervix cancer in the future.

Frequently asked questions:

Why am I having a colposcopy? 

In most cases, our patients have been referred due to an abnormal cervical screening test (CST), which used to be called a `Pap smear’. This test used to look only for precancerous changes in the cells brushed off the surface of the cervix, but three years ago the test was improved to screen for the presence of Human Papilloma Virus (HPV). This was an important improvement because in the vast majority of cervical cancer sufferers, HPV is present in the cervix cells and has caused the progressive change to cancer over a long period of time. Our patients are often surprised to learn that most people have had one or more strains of HPV at some time, but often their immune system has cleared the virus quickly. Some strains of HPV, including HPV 16 and HPV 18, are more dangerous than others, and if these are detected, your GP will send you for colposcopy straight away. However, some of the other strains of HPV can be watched (via a repeat cervical screening test), as long as the cells themselves look normal or show only low- grade changes. You will only be referred if these HPV strains linger long enough to be detected on a second CST.

Occasionally women are referred for colposcopy due to persistent bleeding or spotting between periods, or after sexual activity. Regardless of their screening result, these symptoms should not be ignored.

What should I expect during a colposcopy?

Before the procedure, your doctor will explore your understanding of your CST results and take a full history. She will explain what to expect during the colposcopy and offer you the opportunity to ask questions.

Once you are ready, your doctor will take you to the procedure room. Our registered nurse, Kathy, will then join you, and will help you get into position. She will usually stay with you and keep you comfortable during the colposcopy.

Once you are in position and the procedure begins, most women report feeling a little uncomfortable, but most will not be in pain. Often women report that the procedure feels similar to a cervical screening test, although of course it takes longer. Dr Aubrey will use a microscope to examine the cells of the cervix thoroughly. In most cases, a small biopsy is required, and although the idea of this can make women feel anxious, many women do not feel it. Others report period-like cramps afterwards, but these usually go away very quickly. Most women feel fine afterwards and are able to come back into the consultation room with the doctor to discuss their results.

What happens after the colposcopy?

If a biopsy has been taken, the next step in your management will depend on the results from the laboratory. These take about a week to come back, and your doctor will contact you to discuss what happens next.

If high grade changes are seen, you will need to undergo a small procedure to treat the abnormality. This is performed under general anaesthesia and is therefore done as a day procedure at Mater Hospital Hyde Park. Your doctor will tell you more about this procedure if you require it.

If the biopsy results are normal or show low grade cell changes only, national cervical screening guidelines recommend monitoring. This recognises that most people with HPV will clear the virus within a few years, at which time cervix cell abnormalities will usually also regress. In most cases, surveillance means repeating the cervical screening test again in one year, to see if HPV is still present. This follow-up may be performed by your GP or it can be arranged at our rooms.

The most important thing is that you attend promptly for your colposcopy once you are referred. There is nothing to fear, as Dr Aubrey is experienced and kind, and will perform your procedure with respect for your dignity and privacy.