The Rotunda Hospital Dublin

Colposcopy

The Colposcopy Service in the Rotunda operates in association with ‘Cervical Check: The national Cervical Screening Programme'. It's an outpatient clinic staffed by a dedicated multidisciplinary team.

Changes in CervicalCheck

In 2020, CervicalCheck changed the way it is carrying out and reporting tests being performed for the detection of changes in the cells of the cervix.

Up until now you will have had conventional cytology (‘smear tests’) with possible additional testing for the HPV virus. It is now known that the vast majority of abnormal cells and cervical cancers are associated with the finding of the human papillomavirus (HPV) in the cancer cells.

Screening first looks to see if you have any of the high-risk types of human papillomavirus (HPV) that cause cervical cancer.

If HPV is found, your same test sample will be checked to see if you have any abnormal (pre-cancerous) cells in your cervix.

HPV cervical screening:

  • is a better way of cervical screening
  • prevents more cancers
  • means some people will have fewer tests

If you have had a smear test in the past, having a cervical screening test will feel the same.

Philosophy of Care

Our philosophy is to excel in delivering safe and high quality patient centered care. We acknowledge that each patient is an individual and has unique needs. We endeavour to meet individual needs, requirements and wishes whilst maintaining dignity and respect.
Our care is provided by a highly committed multi-disciplinary team supported by evidence based practice and research. We are committed to lifelong learning and understand the importance of the continuous development of skills and knowledge. Our philosophy will be delivered through a solid commitment to care excellence, inclusivity and collaboration

Colposcopy

A colposcopy is a simple examination that is carried out in the same way as a smear test. A doctor or nurse will look at your cervix (neck of the womb) using a type of microscope called a colposcope. During the examination, a liquid or dye may be applied to the cervix to help identify any changes to the cells and to decide if any treatment is needed.

The colposcopy service in the Rotunda operates in association with ‘CervicalCheck’, the national cervical screening programme. It’s an outpatient clinic staffed by a dedicated multidisciplinary team, led by Dr Vicky O’Dwyer, consultant obstetrician and gynaecologist.

CervicalCheck has established a network of quality assured colposcopy clinics in the event that a woman requires further investigation following a smear test. The vast majority of women screened as part of the national cervical screening programme will only require a smear test. A small minority (2-5%) of all women screened will require further investigation or treatment at a dedicated colposcopy clinic.

Cervical Check

CervicalCheck has established a network of quality assured colposcopy clinics in the event that a woman requires further investigation following a smear test. The vast majority of women screened as part of the national cervical screening programme will only require a smear test. A small minority (2-5%) of all women screened will require further investigation or treatment at a dedicated colposcopy clinic.

Colposcopy FAQs

What is HPV?

HPV (Human Papilloma Virus) is a common virus which infects skin or mucosa. Many women will have an HPV infection at some time in their lives, usually in their teens or twenties. However, most women clear this infection spontaneously with no long-term effects. Approximately 8 out of 10 adults have had the infection at some time and it is rare for the infection to show any effects at all. However, 5% of women will have abnormal cervical screening test, 1-2% will develop pre-cancerous cells (CIN) and a tiny minority of those pre-cancer changes progress to get cervical cancer despite the efforts of the screening programme.
HPV is transmitted through sexual activity it is not a sexually transmitted disease.

What is a HPV Cervical Screening Test?

HPV testing has recently been introduced as part of the Cervical Check screening programme to help identify those who need further testing with colposcopy. The old smear test looked for abnormal cells first. But finding HPV first is a better way to screen. If HPV infection is found early we can monitor it and offer you treatment if there are any changes to cells in your cervix.
If 1000 women are screened about 20 will have abnormal (pre-cancer) cervical cells:
15 of these 20 will be identified through the old smear test.
18 of these 20 will be identified thought the new HPV cervical screening test.

When will I be offered a HPV test?

• Women aged 25 to 29 are offered a test every 3 years
• Women aged 30 to 65 are offered a test every 5 years
• Women are offered a HPV test 6 months after treatment in the colposcopy clinic

What do I need to know about HPV Vaccines?

The HPV vaccine is safe and effective. It is widely recognised that the HPV vaccine is most effective when given before a person becomes sexually active. If a person is already sexually active, the HPV vaccine may be less beneficial due to the fact they may have already been exposed to one or more of the HPV types targeted by the vaccine. Gardasil 9 is the HPV vaccine currently in use in Ireland. Presently, Gardasil 9 vaccine is offered to boys and girls in their first year of secondary school at 12-13 years of age. Gardasil 9 protects against the types of HPV that cause 9 out of 10 cervical cancers.

Who is referrred to Colposcopy?

You are referred to colposcopy if you have:
• Two positive HPV tests and no abnormal cells detected at a screening test.
• One positive HPV test and abnormal cells detected at a screening test.
• The GP or nurse who carried out the screening test thought your cervix did not look as healthy as it should.
• If it was not possible to give you a normal (negative) result after screening tests due to insufficient cells.

What can I expect?

First of all you will be seen by friendly staff who are dedicated to this clinic. They will take time to discuss your cervical screening test result before the examination. The examination takes 10 minutes. The cervix is viewed using a speculum (the instrument needed for your smear to be taken). The doctor or nurse will put one or two solutions on the cervix and look for changes that indicate the presence or absence of pre-cancerous changes (or CIN) using a microscope with a light. A biopsy may be taken and sent to the laboratory. Some women are offered a treatment at their first visit rather than a biopsy.
Treatments options include:
• LLETZ – a heated wire loop removes the abnormal cells
• Cold coagulation – a heat source is applied to the cervix to destroy the abnormal cells
• Conservative management – The monitoring of CIN II changes for up to two years.

When will I get my results?

You will get a letter with the results of your biopsy or following a LLETZ treatment. A copy of this letter is also sent to your GP. We aim to send results letters within 8 weeks of biopsy or treatment. A follow up plan is included in your results letter.

Is Colposcopy safe in pregnancy?

Colposcopy is safe in pregnancy. You will usually be offered an appointment at 20 weeks gestation. For most women a biopsy and treatment can be deferred until 3 months after giving birth.

Appointment Information

Tel: 01 – 817 6841

Healthmail: [email protected] 

Colposcopy Enquiries

For queries about the colposcopy examination, telephone:

  1. 01 – 817 6844
  2. 01 – 817 6874
  3. 01 – 817 2518
Referrals

The referral form will be reviewed by a doctor and nurse colposcopist an appointment will be sent to the patient. The referring cervical smear taker will also be notified of the appointment date. We aim to see every person within 8/52 of referral.

The referral form should be sent to:
Colposcopy Unit,
The Rotunda Hospital,
Parnell Square,
D01 P5W9.
Dublin 1.