The Dysplasia Clinic at Queensway Carleton Hospital offers state-of-the-art care for patients with dysplasia, as well as related conditions. The Dysplasia Clinic provides screening and treatment options including colposcopy and necessary treatment options for women with abnormal Pap results.
The clinic is open Tuesday through Friday by referrals only.
Please remember that this is a scent-free hospital and to arrive at Patient Registration ½ hour prior to appointment time.
Information about your appointment:
Your appointment involves meeting and talking with the Doctor, repeating your Pap smear and have a colposcopy.
Dysplasia and Vulvar Care Clinic Information Sheet
What is a Colposcopy?
This is a way the doctor can examine your cervix closely. A coloscope is an instrument that shines a light on the cervix and magnifies it. You will be able to watch the procedure on a monitor, if you wish.
Why is a Coloscopy performed?
A Coloscopy helps the Doctor to find the reason for the abnormal Pap smear.
Who will be present?
A Physician and a Nurse will be present during your appointment.
Before the procedure:
You will be brought into the clinic, and the Doctor will talk with you. Your Pap test results will be reviewed, and you will have the opportunity to ask questions.
- You will lie on an examination table, with your legs in stirrups.
- The Doctor will insert an instrument called a speculum into your vagina to help to expose the cervix.
- The Colposcope will be placed near the vagina.
- The Doctor will then look through the coloscope to examine your cervix.
- Your cervix will be soaked with vinegar. This solution helps to make the abnormal tissue turn white and become more visible. You may feel a mild burning sensation.
When will I get the result of my Coloscopy?
It usually takes about 2 weeks for the Doctor to get the results. We will not call you with the results. They will be discussed at your next appointment. We will call you only if the results change, and the Doctor needs to see you earlier than scheduled.
Cervical Cancer: How to reduce your risk
Cervical Cancer: Understanding your diagnosis
Cervical Dysplasia Guide
Dysplasia and Vulvar Care
Cone Biopsy of the Cervix Guide
Information on a pap test
Sexuality and you
All about cervical cancer brochure
HPV: What you should know
Care of the vulva:
- When you bath or shower, do not use soap until the very end, and do not apply it directly to the genital area.
- Never use perfumed bath oil or foam.
- Dry the genital area with a hairdryer, set on the lowest setting or gently pat yourself dry. Do not rub or scratch the vulvar area.
- Do not use nylon underwear or pantyhose, use only cotton underwear.
- Avoid tight fitting clothing and polyester slacks.
- Whenever possible, do not wear underpants. This allows the vulva to be in contact with air.
- Do not wear underpants to bed at night.
- Wash underclothing with a mild non perfumed soap such as Ivory Snow. Do not use fabric softeners in the washer or dryer.
- Do not use deodorized tampons, pads or perfumed products in the genital area.
- Do not use panty liners for increased vaginal discharge, instead change your underwear more frequently.
- Use only white, non – scented toilet paper. Do not use recycled toilet paper.
If the vulva is itchy, take a cool bath, and then apply a thin layer of vegetable shortening, olive oil or prescribed cream. Cotton gloves should be worn if you scratch this area when you sleep.
You may find the consumption of alcohol, and acidic citrus fruits and drinks may cause the vulva to feel worse. If burning/itching is aggravated by intercourse, possible causes are:
- allergy to your method of birth control ie condoms, spermicides or foam.
- the lack of sufficient lubrication- try using a non-perfumed lubricant such as KY,Astroglyde or Replens.
- a dry vagina due to low estrogen levels if you are menopausal or near menopause, Speak to your Family Doctor or Gynecologist regarding the possibility of hormone cream or pill vaginal medication.
What is Loop Electrosurgical Excision Procedure (LEEP)?
LEEP is a newer technique than the laser procedure and is designed to diagnose and/or treat the cervix (neck of the womb) of women with abnormal Pap tests. There are a number of other names to describe the procedure, including Lare Look Excision of the Cervix (LLEC), Loop Cone Biopsy and, in Britain the term Large Loop Excision of the Transformation Zone (LLETZ). All depict a procedure that uses an electrical energy generator, attached to a fine wire loop that when energized, functions as a precise and rapid surgical tool. This instrument is then directed toward an abnormal area on the cervix and is used quickly, effectively and painlessly to remove the abnormal tissue.
Who will benefit from this procedure?
Any woman with a significantly abnormal Pap smear may benefit. LEEP is particularly useful in patients who have abnormal cells entering into the cervical canal. This area is at the greatest risk of containing invasive cancer and thus this area must be removed and examined in the Coloscopy Suite, in a nearly painless fashion, the woman avoids the time, discomfort and cost associated with an in-hospital visit for a cone biopsy. Because of the ease of performing this procedure, general anesthesia is rarely necessary.
How should I prepare for LEEP?
No special preparation is needed. You should eat the day of the procedure.
What should I expect during the procedure?
You will disrobe form the waist down and proceed in the same way as you would for a Pap test. The physician will examine the cervix with the Coloscope. Then a small amount of local anesthetic is injected into the cervix. In the vast majority of cases, this is painless. You will however, feel some pressure. A mild solution of vinegar or iodine is applied to the cervix to highlight the abnormal area. You will then hear two sounds - the fan of a suction machine and the humming sound signal from the electrosurgical generator. It is very important to stay very still at this point (approximately 10 seconds). The physician then uses the device to stop any bleeding. Sometimes a yellow paste called Monsel's is applied to the cervix to further prevent bleeding. The speculum is then removed from the vagina and the procedure is completed. The procedure usually takes about ten minutes from the time you lie down until the time it is over.
What should I expect after the procedure?
Immediately after the procedure there should be a discharge that is dark brown to black. The amount varies so it is advisable to wear a sanitary pad (not a tampon). in some instances there will be a bloody discharge, particularly between day six and day fourteen following the procedure.
There may be some changes to your next period. Menstrual flow might start earlier or later than expected and may be heavier. You may expedience more cramps.
When should I be concerned enough to phone?
If bleeding becomes very heavy and bright red or if you experience clotting or if you have a fever and foul smelling discharge or severe cramping, you should call the clinic at 613-721-2000, ext. 2492 or go to the Emergency Department.
What restrictions are there following the procedure?
You will be given a sheet of instructions after the procedure. You can resume normal activity after the procedure with three important exceptions. You should not use tampons, not have sexual intercourse and not participate in vigorous exercise for 3 weeks following the procedure.
When do I return for follow up?
A follow up appointment will be arranged for 4 to 6 months after the procedure. Your follow up appointments are very important. After you have had 3 normal Pap tests at the clinic, you will return to your Family Doctor for annual Pap tests.
Are there any long-term effects from LEEP excision?
The effect on the cervix is identical to, and in most cases, less than that associated with other procedures such as cryotherapy (freezing), laser therapy, or surgical conization. With the exception of deep cervical conization, none of these procedures has been associated with infertility, pregnancy loss, or premature labour. With any of these procedures there is a small number of women who will develop a cervical stenosis.
Loop Electrosurgical Excision Procedure (LEEP) discharge instructions