Colposcopy - Treatment 

Treating abnormal cells in the cervix 

You may require treatment if the results of your colposcopy indicate abnormal cells in your cervix.

Treatment typically aims to remove the area of abnormal cells. This usually involves removing an area of the cervix about the size of a finger-tip.

The specific type of treatment recommended will depend on the number of abnormal cells in your cervix and how advanced the abnormalities are.

The aim of treatment is to remove the abnormal cells while minimising damage to healthy tissue. Treatment is nearly always 100% successful, and it is unlikely cell changes will occur again.

Timing of treatment

It is often possible to have treatment at the same time as your colposcopy. This may be more convenient for you than having to make another appointment for treatment at a later date.

Some women find waiting for treatment causes anxiety, and prefer to be treated as soon as possible. Others prefer time to think about their treatment and schedule it for another time.

Some more intensive treatments cannot be done on the same day as a colposcopy. Your colposcopist will advise about the best time for your treatment to be carried out. They will also be able to discuss treatment options with you, and what each type of treatment involves.

Some available treatments are discussed below.

Large loop excision of the transformation zone (LLETZ)

In the UK, large loop excision of the transformation zone (LLETZ) is the most common treatment for abnormal cervical cells. LLETZ is also known as loop diathermy, loop cone, loop biopsy, or loop excision.

LLETZ can sometimes be carried out at the same time as a colposcopy and involves cutting out the area of the cervix where abnormal cells have developed. This is done using a thin wire loop that is heated with an electric current. A small ball electrode is used to seal the wound.

LLETZ usually takes 5-10 minutes. A local anaesthetic is usually used to numb the area, this is injected into your cervix with a needle. The procedure is not usually painful, although you may feel some pain similar to period pain.

If a larger area of the cervix needs to be treated, the procedure will take longer and you may need a general anaesthetic.

You will need to bring a sanitary towel with you as you will bleed after having LLETZ. You may also have some light bleeding for several weeks after the procedure.

After having LLETZ, you should avoid:

  • using tampons for four weeks (use sanitary pads instead)
  • having sexual intercourse for four weeks
  • heavy exercise for two to three weeks

These all increase your risk of developing an infection after the procedure has been carried out. 

There is some evidence to suggest women who are treated with the LLETZ procedure have an increased risk of premature birth in future pregnancies. However, in most cases, the benefits of treatment will greatly outweigh this small risk. Your doctor can advise further about this if necessary.

Cone biopsy

It is not possible to carry out a cone biopsy at the same time as a colposcopy. A cone biopsy is a minor operation that may require an overnight stay in hospital. It is carried out less commonly than LLETZ and is only really used if a large area of tissue needs to be removed.

A cone biopsy is carried out under general anaesthetic. A cone-shaped piece of tissue is cut away from your cervix with a scalpel. The section of tissue removed may include the whole area of cervix where the abnormal cells are located. The tissue will be sent to a laboratory for closer examination.

Following a cone biopsy, a piece of gauze (a dressing made of absorbent material) may be placed in your vagina to help stop any bleeding. If you require a gauze pack, you may also need a catheter inserted (a thin tube that drains urine from your bladder) as the pack can sometimes press on your bladder. You may need to stay in hospital overnight – please ask your doctor or nurse for more advice.

It is normal to bleed for up to four weeks after having a cone biopsy. You may also have some period-like pain, although any discomfort should only last for a couple of hours. Painkillers can be used to help ease the pain.

Take plenty of rest during the first week after having a cone biopsy. You will not need to stay in bed, but you should avoid tasks such as heavy lifting. Also, avoid vigorous exercise and having sex during the first four to six weeks after the biopsy. After this time, the tissue in your cervix should have healed.

While recovering from your operation you may also find it useful to arrange for a relative or friend to stay with you for a few days to help with difficult tasks.

Other treatments

Abnormal cells can be treated in several other ways, without removing them. Your doctor can give you more information and advice about the procedures briefly outlined below and whether they are appropriate to your circumstances.

Cryotherapy

Cryotherapy is a form of treatment that involves freezing and destroying any abnormal cells. During the procedure, you will lie on a couch and a doctor will insert an instrument called a speculum into your vagina. They will then freeze and destroy any abnormal cells.

During cryotherapy, liquid carbon dioxide is passed through a probe and directed at the abnormal cells. The tissue will be frozen for two to three minutes, and the process may be repeated if necessary. 

You may feel period-like pain during cryotherapy, and for a short time after the treatment has finished.

Laser treatment

Laser treatment involves the doctor using a laser to pinpoint and destroy any abnormal cells on your cervix. A local anaesthetic will be used to numb the area being treated.

The abnormal area will be burned away using a hot beam of light produced by the laser. There may be a burning smell during this procedure, but this is normal and nothing to be worried about.  

You can return home as soon as the laser treatment is finished.

Cold coagulation

Cold coagulation involves applying a heat source to the cervix that burns away and removes the abnormal cells. You may feel period-like pain during cold coagulation treatment, and for a short time afterwards.

Hysterectomy

A hysterectomy (surgical removal of your womb) will only be considered if abnormal cells on your cervix have been found more than once or if they are severely abnormal.

Removing your womb will usually only be an option if you have decided not to have any more children or you have had the menopause.

After treatment

Following treatment on your cervix, you are likely to be advised to avoid:

  • using tampons for four weeks after your treatment
  • having sexual intercourse for four weeks after your treatment
  • going swimming for two weeks after your treatment

Ask your GP or call the clinic if you have any questions about the colposcopy examination, biopsy procedure, your results, or possible treatment options for abnormal cervical cells. Your GP or staff at the clinic will be able to answer any queries or discuss any of your concerns.


Page last reviewed: 17/10/2012

Next review due: 17/10/2014

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Comments

The 9 comments posted are personal views. Any information they give has not been checked and may not be accurate.

MissJadeWright said on 31 March 2014

I have my colposcopy for the 29/4/2014 I have borderline abnormalities and high risk HPV. I am worried as I have bad leg pain which runs from my hip to knee and ankle I also have period pains along side my hip, but i'm not on my period. I have reported this to my doctor who said it is not related.

Yet i have read of cervical cancer and hip pain so I am unsure. I have had a hip and pelvic xray which came back normal.

Because of the cramps I'm getting today and the constant leg pain I have tried to call the clinic where the colposcopy is scheduled the Head Nurse is on holiday and her replacement does not answer the phone. I really need help I'm in pain has anyone had a similar experience?

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Ellygee said on 25 March 2014

I'm 25 and had my first smear test 4 weeks ago. To my horror it came back abnormal with high grade dyskaryosis :( instantly I panicked.
Went for my colposcopy yesterday resulting in a loop biopsy. I was so nervous, now I can say it wasn't as bad I thought it was going to be. The worst part is having to wear sanitary towels for a few weeks... Not worn them since I was about 12!!!
Obviously it was uncomfortable but didn't feel anything once I'd had the local anaesthetic. The nurses were lovely and made me feel at ease.
I wish I hadn't put off going for my smear for nearly a year...!!!

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Miss Green eyes said on 05 February 2014

Kayls87, go get it checked out asap! I've been struggling with these abnormal cells since August 2011! I had my first smear and at that appointment I said to the nurses that I was trying for a baby! (No2.) they said stop trying till this was sorted but it was too late by my next appointment I was already pregnant! Every month or so I had to have a smear to check up on these abnormal cells which was hell being pregnant and all. I've had numerous treatments to remove then and one under general anaesthetic! So my daughter is now 20 nearly 21 months old and I'm still having colposcopy appointments! I was told the results of a previous check up was good and the smear was negative but a little while ago received a letter saying a biopsy taken showed CGIN which I just looked up online and it means I still have abnormal cervical cells! So much for this all being over! Missed my last appointment and have heard nothing since but since finding out tonight that my cells are still abnormal I will be contacting the hospital asap! Point is that however scared you feel about finding out what's going on or getting treatment, nothing could compare to leaving it and it turning into cancer! Get it sorted! I will!

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Kayls87 said on 31 January 2014

I am 26. i have had three smears since i was 24 due my a consultant ordering them to be done. for the first two smears the results were borderline and the third came back abnormal and needed to colcoscopy. I went and the said half of my cervix had abnormal cells on it. They requested i went bk for biopsy as i was pregnant. I didnt go back because i was frightened and still am to this day. i have an appointment to go bk on the 11th feb. Are my feelings normal to have and is it bad for half of the cervix to have abnormal cells please any information that you have i will be very grateful as i am very scared. : (

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Dizzi said on 26 November 2013

Lyns, I know what you mean. I'm 26. My first smear came back as abnormal, had a colp but I was told not to worry and come back in a year.

A year later, I go back and get a letter saying there's been a "high grade change". Me - instant freak out.

Got to my next appt to be told high grade just means it needs treatment. Well why not just say that then?!

So, I was not informed what the treatment was, in anyway. Even after having a loop extraction yesterday, I still had to use the internet to get information on what it was...

Don't get me wrong, the ladies were lovely and did everything they could to make me comfortable, but a bit of info before hand definitely would have helped

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Lyns82 said on 09 November 2013

On what planet do the nhs think it acceptable to send a letter to a woman telling her that she has a serious problem that needs treatment with no information as to exactly what that treatment will be or what it means? Oh yes, that would apparently be this planet.

Just opened my letter on a Saturday, so of course my only source of information about it is the Internet, and we all know how reliable that is! I could have a few cells burnt off or require a hysterectomy!

Absolutely appalling.

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Scottishkirsten said on 08 November 2013

I got a letter this morning saying I need to go under general and just need to wait for more info. Thank goodness for this site to give more information and hope don't need to wait too long for the procedure.

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cervix123 said on 09 October 2013

Hi ladies im 29 had lletz twice over the past 3 years and now being offered a hysterectomy. I was just wondering if anyone else has had this done due to abnormal cell and how it went for them any advise would be appreciated thanks.

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madamh said on 26 August 2013

Problems started again had colposcopy and other treatment been having yearly smears for a number of years now another abnormal smear test result appointment for treatment again. I am 60. I'm panicking...

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HPV testing after treatment

Six months after receiving treatment for abnormal cells in your cervix, a cervical screening test should be carried out to check for any cell changes.

If the test shows no or mild changes, the sample will also be tested for human papilloma virus (HPV).

If HPV is not found, you will not need to be screened for another three years.

If HPV is found, or more significant cell changes are detected, you should be referred for another colposcopy.