What is Involved in 'Further Investigation' of Abnormal Pap Smears?
When you are referred to the hospital you will be seen by a gynaecologist, pathologist or genitourinary medicine physician who is specially trained in diagnosing and treating abnormalities of the cervix. The technique used is known as colposcopy.
The staff in the colposcopy unit realise that you will be quite anxious and will try to put you at ease. Colposcopy involves no more than the doctor passing a speculum (like when you have the smear taken), and then using a modified microscope (colposcope) to look at the cervix.
The colposcope does not come into contact with you and the doctor looks into it at the end of the couch. This magnification makes it easier to see all of the transformation zone of the cervix and look for any abnormal areas that might be causing the unusual cells on the smear.
If an area looks abnormal, a tiny biopsy (sample) is taken - this is not particularly painful as the biopsy is so small. This allows the pathologist who looked at your smear to see exactly where the unusual cells were coming from.
Knowing this, the doctor doing the colposcopy can treat the abnormal area accordingly. Most treatments need no anaesthetic or only local anaesthetic and are carried out in the colposcopy unit.
Treatment usually only takes about 20-30 minutes at most, and results in few after-effects. You will be asked to abstain from sex for 10 days or so.
Very occasionally, when the upper end of the unusual area cannot be seen, a general anaesthetic may be needed for the treatment. Some units also have a 'see and treat' policy, where biopsy and treatment occur together in one visit.
Visit the Colposcopy UK website for a more detailed discussion.