Aftercare following cervical biopsies

Today you have had samples (biopsies) taken from your cervix. Your nurse has explained the following, please read it again when you get home.

What to expect after a biopsy

You may get a discoloured discharge if the biopsy site has been cauterised with Monsel’s paste.

You may get some silvery black discharge if the biopsy site has been cauterised using silver nitrate.

These will stain your underwear and you are advised to use pads or pant liners. You may have spotting or light bleeding for a few days. You should not have intercourse until 48 hours after any spotting has finished. If you have heavier bleeding you should telephone the emergency ward:

Clinic 24 – 01223 217636 (Monday to Friday 08:00 - 20:00, weekends 08:30 – 14:00. Closed bank holidays. Please telephone Daphne Ward on 01223 349755 at all other times.)

What do the results mean?

It has been explained to you that the result of the biopsies taken today may show that you have some abnormal cells present in the cervix, which if left untreated, might in the future become cancer. These cells are easily removed by diathermy loop treatment.

The cells that are being looked for following your biopsies are described below.

The technical term for pre-cancerous cells is cervical intraepithelial neoplasia (CIN). There are three grades according to the degree of change:

• CIN1: Means only a third of the cells are abnormal in the affected area. Usually treatment is avoided as these changes can sometimes return to normal. You may be sent an appointment to return to the colposcopy clinic for a repeat smear and colposcopy.
• CIN2: Means two thirds of the cells are abnormal in the affected area.
• CIN3: Means all of the cells in the affected area are abnormal.

Only rarely will a biopsy show cell changes that have already developed into cancer.

If your biopsy shows CIN 2 or 3 then you will be sent an appointment to return to the colposcopy clinic for treatment to the affected area on your cervix causing the abnormality.

However some women with CIN2 are managed conservatively instead of offering them treatment as some of these abnormalities can self-resolve.

It is very important that you do not become pregnant until your treatment has been completed as treatment cannot be performed whilst you are pregnant.

Loop diathermy treatment (LLETZ)

This takes place in the colposcopy outpatient clinic. You have a local anaesthetic injected into the cervix and treatment takes approximately 10 minutes. We advise that you make arrangements to have a restful day. Most women find it helpful to have someone to accompany them to the clinic. You should not cycle home. If you are unaccompanied you may rest in the waiting area before driving home.

Following treatment you will have a blood stained discharge for approximately three to four weeks. Please use pads not tampons until the discharge has finished. Avoid using tampons for four weeks. This is to prevent infection and further bleeding.

You may have bleeding after treatment and at any time during the following three to four weeks, especially around the seventh to twelfth day when pieces of scab may be shed. You should refrain from intercourse for four weeks. This is to prevent infection and further bleeding.

You will be advised to avoid heavy lifting for at least 24 to 48 hours after treatment if possible. Other normal activities including light exercise may continue. There is a risk of heavy bleeding following the treatment. In view of this we usually advise that you avoid going abroad within four weeks following treatment. There are no known health grounds for avoiding travel following treatment. However, medical attention for complications arising from the treatment may not be covered by insurance and you are advised not to go swimming for at least two weeks. You may experience a temporary change in your menstrual pattern following a loop diathermy treatment.

Your appointment

You will receive a letter within four weeks informing you whether or not you require treatment.

If you have not received the expected letter or appointment after four weeks you should telephone the clerical co-ordinator on: 01223 216603. Results will not be given over the phone.

If you have a coil (IUCD or IUS)

If you have a coil this may be removed at the time of treatment. There is a risk of becoming pregnant if the coil is removed at the wrong time in the cycle. From your last period before treatment you should use another form of contraceptive, ie your partner should use a condom.

If you would like to speak to the colposcopy nurse you are very welcome to telephone between:

12:45 – 15:00 Monday – Friday on: 01223 216603

If you are unable for any reason to come on the appointment date given, it is absolutely essential that you telephone the clerical co-ordinator on 01223 216603 (09:00 to 14:00 Monday to Friday). Otherwise the appointment is wasted and another patient is denied the opportunity of attending. You should also phone the clerical co-ordinator if your name, address or GP have changed since your last visit.

Useful websites

• Cervical screening (NHS website) (opens in a new tab)
• BSCCP (opens in a new tab)