Cervical Disease Clinic

Colposcopic examination is a specialized procedure to diagnose the level of cervical abnormality and thus allow appropriate planning for subsequent management. The procedure of colposcopic examination is similar to the routine gynaecological examination. The doctor will first insert a vaginal speculum into the vagina so that the cervix is easily seen. He/She will then use a telescope-like instrument to examine the cervix at a distance of about 12 inches. Some solution will be applied and the cervix will be re-examined. During the examination, the doctor may take biopsies from any suspicious areas of abnormalities for histological diagnosis. The whole procedure takes about 15 to 20 minutes.

LSIL (Low-grade Squamous Intra-epithelial Lesion) indicates very early and mild changes in the cervix. At least 50% of these cases will spontaneously regress within a year or two. Therefore most women are put under observation with no immediate treatment. However, treatment may still be given if the lesion is persistent. Only a small proportion of women may have persistent disease that progresses into cervical cancer. As such deterioration can often be detected by regular cervical cytology, with the use of appropriate treatment, chances of the persistent disease developing into cancer can be reduced.

If colposcopy showed HSIL (High-grade Squamous Intra-epithelial Lesion), treatment will be required as the chance of cancerous changes is much higher. LEEP (Loop Electro-surgical Excision Procedure), Laser Therapy and Cryotherapy are minor operations used to prevent the progression into cancer. In Hong Kong, LEEP is the most preferred procedure to treat precursors of cervical cancer.

LEEP is minor operation used to treat precursors of cervical cancers, so as to prevent the progression of the condition into cancer. When the result of cervical cytology shows severe dysplastic changes (HSIL) and colposcopy/biopsy confirms moderate/severe cervical intra-epithelial neoplasia (CIN 2/3), LEEP is recommended. The abnormal cervical tissue is removed and sent for histological examination, hence serving dual purposes of treatment and confirming the diagnosis.

LEEP is usually done after menses to ensure that the woman is not pregnant. The whole procedure, which takes about 20 to 30 minutes, can be done under local anaesthesia or general anaesthesia, depending on the size and extent of the lesion and characteristics of the patient. Even when the operation is done under local anaesthesia, the patient would not feel much pain. There would be mild bleeding for a couple of weeks after the operation. Sexual intercourse, swimming and use of tampons should be avoided during this recovery period.

More frequent cervical cytology tests are required in the initial period after examinations or treatment. Patients should pay follow-up visits according to their doctor's recommendations. If thereafter all cervical cytology tests show normal results for a certain number of years, the woman can then get back to routine screening programs.