While many gynaecologists offer colposcopy,
very few truly specialise in the field.
As a gynaecological oncologist, colposcopy is a genuine passion for Mr Angus McIndoe. Patients can rest assured they are in the capable hands of an experienced and knowledgeable consultant. This private colposcopy clinic has the full range of treatment options available.
An abnormal smear test is very upsetting. For most women, the changes will be low grade and will go away without any treatment at all. Even if the abnormality is high grade, treatment is very simple and quick.
Answering your questions is the most important first step. We will take time to look at your results and explain what they mean. Colposcopy is the next step, to examine the cervix in detail and find out whether the abnormality is likely to go away without treatment, or whether you will need treatment to remove the abnormal skin.
If treatment for CIN is necessary, this is a simple procedure. It causes minimal discomfort and takes about 10 minutes. We usually use local anaesthetic. However, we can arrange a general anaesthetic if preferred.
We plan each treatment and map out the abnormality. We then carefully remove the abnormal skin under direct vision. A single treatment is all that is necessary, and the risk of recurrence is very low.
Treatment for HPV infection of the cervix is now available. This has a 75% success rate for clearing the virus infection. We can give HPV vaccination when asked for. This prevents reinfection with HPV.
Colposcopy Examination £495
Includes consultation, smear, and all clinic fees.
Colposcopy and biopsy £685
Mr McIndoe was wonderful. He listened to everything I had to say and provided sound feedback. I’ve been looking for a good Gynaecologist for some time now and have finally found one! I would definitely recommend Mr McIndoe and his wonderful staff!– Anne, Oxford
What is Colposcopy?
Colposcopy is a common procedure that uses a microscope to look at the cervix for abnormalities. The colposcope magnifies the image 10 to 20 times, allowing careful examination of the cervix. In some cases, we take a biopsy for further review in the laboratory.
This procedure is not painful if done sensitively. It is like a smear test, although it takes slightly longer. The most common finding is low-grade changes which usually resolve without treatment. Even if we detect high-grade changes, treatment will easily remove the small area of skin that is abnormal.
How does colposcopy help?
The cervical smear test is a screening test which picks up many abnormalities. Unfortunately, it may not be exact in classifying the severity of the abnormality. In women who have low-grade changes on the smear, one in ten will have a high-grade lesion. Colposcopy is a diagnostic test that can find those women that already have a high-grade abnormality. Using the colposcope, we can see certain changes in cervical tissues. These include abnormal blood vessels, tissue structure, colour, or patterns. If we suspect a high-grade abnormality, we usually take a biopsy.
What happens during Colposcopy?
We use the colposcopy to show areas of abnormality in the skin of the cervix. We apply a very dilute solution of acetic acid to the cervix. This solution makes abnormal skin looks white and patterned. This allows us to recognise it, when compared with healthy skin. Sometimes we use Lugol’s iodine. This stains normal skin “mahogany brown” but stains abnormal skin less darkly.
What is a smear test?
A cervical smear test, or Pap test, is a simple screening test to find women who might have abnormal cells in the skin of the cervix. Cells from the surface of the skin of the cervix lose their attachment to adjacent cells. We collect these cells with a brush and wash the brush in liquid to detach the cells. In the lab, a machine spreads the cells evenly on a microscope slide to allow better examination by the pathologist.
The kind of changes we are looking for are where the cells are growing faster than they should do, and which, if left, might become a cancer. These changes develop very slowly, and only progress over years rather than days or weeks.
What is dyskaryosis?
Dyskaryosis is the technical term used to describe the appearance of single cells. The smear test looks at cells that have come loose from the skin. We collect these cells with a brush and save them in a special fluid. When cells are abnormal or borderline on a smear test, the cells are dyskaryotic, and the smear test shows “dyskaryosis”.
Our skilled pathologist can grade these changes as mild, moderate and severe dyskaryosis depending upon the degree of abnormality seen within the cells. Mild dyskaryosis on the smear test tends to suggest mild dysplasia or CIN1 in the skin of the cervix. Moderate dyskaryosis suggests moderate dysplasia or CIN2 on the cervix. Severe dyskaryosis suggests dysplasia or CIN3. However, the agreement is not always as consistent as that.
A skilled colposcopist will compare the results of one or two smear tests with the appearance of the cervix using the colposcope. Sometimes, we take a biopsy from the cervix during colposcopy This is particularly important if we suspect a high-grade abnormality (CIN2 or CIN3).
What is colposcopy?
Colposcopy is a careful examination of the cervix. We use a colposcope which is a special kind of microscope. The examination is very like a smear test. The colposcope stays outside the body and magnifies the view of the cervix 10 to 20 times. The colposcopy procedure should not hurt if done sensitively. Occasionally women experience some discomfort from the speculum. We use the same instrument as for taking a smear.
We appreciate that this type of investigation can be daunting. However, most women find this much better than they imagined. The colposcopist should undertake the examination gently, allowing women time to feel comfortable. The procedure only takes a few minutes.
What is CIN?
CIN is short for Cervical Intraepithelial Neoplasia. This is a descriptive phrase. “Neoplasia” is a general word for all abnormalities where the cells are growing faster than normal. “Intraepithelial” means that we see the fast-growing cells in the skin only, and there is no evidence of them spreading anywhere else. “Cervical” describes that these changes are occurring on the cervix. These changes refer to the appearance of the abnormal skin, looked at as a section of tissue in a cervical biopsy. The term dysplasia means the same as CIN.
Dyskaryosis, on the other hand, describes the appearance of individual cells on a smear test. CIN1 or mild dysplasia usually correlates with a smear showing mild dyskaryosis, CIN2 or moderate dysplasia with moderate dyskaryosis and CIN3 or severe dysplasia with severe dyskaryosis.
What is dysplasia?
Dysplasia is a term used to describe abnormal changes in biopsies. The term dysplasia originates from Greek words. “Dys” means abnormal, and “plasia” means growth. Dysplasia therefore means simply abnormal growth. It means the same as CIN.
Mild dysplasia describes low grade changes called CIN1, moderate dysplasia more significant changes also called CIN2, and severe dysplasia describes high grade changes also called CIN3. CIN3 changes involve the full thickness of the skin. In the same way, moderate dysplasia involves the lower two thirds of the skin and mild dysplasia the lower one third.
What is LLETZ/LEEP?
LLETZ is the name of a treatment technique. Another name for LLETZ, used more commonly in the USA, is LEEP. LEEP or LLETZ involves the removal of the small piece of the skin of the cervix containing CIN using an electric current in a wire loop. We usually perform LLETZ or LEEP procedures in an outpatient setting with local anaesthetic. We use general anaesthetic when the procedure is difficult. The procedure itself is painless when performed carefully by a skilled and experienced doctor.
What is HPV?
HPV is short for Human PapillomaVirus. The HPV viruses are a large group of viruses responsible for a range of diseases in many areas of the body. Benign HPV diseases are usually warts. HPV are remarkably specific about which area of the body they will grow. Type 1 is the most common virus causing plantar warts on the sole of the feet. Types 2 and 4 cause hand warts, and HPV 6 and 11 cause genital warts. HPV 16 and 18 are the most common viruses associated with high grade dysplasia or CIN on the cervix.
What is cervical cancer?
Cervical cancer, or cancer of the cervix develops from CIN (dysplasia). In CIN lesions, we find abnormal cells in the skin of the cervix only. If these cells break through into deeper tissues, a cervical cancer develops but fortunately this happens very rarely. Most CIN lesions stay confined to the skin for many years. We can easily treat these abnormalities with excision before they become a cancer.