Having a punch biopsy on your vagina or cervix

A colposcopy has identified an area on your vagina or cervix (neck of your uterus/womb) which may contain abnormal cells. A punch biopsy is carried out to remove a tiny portion of the abnormal-looking area so that it can be examined more closely in the laboratory. The laboratory will diagnose any cancerous or pre-cancerous changes.

Pre-cancerous changes on the cervix are called ‘cervical intra-epithelial neoplasia’ or CIN. Pre-cancerous changes on the vagina are called ‘vaginal intra-epithelial neoplasia’ or VaIN. There are 3 grades of CIN/VaIN. The grades describe how far the abnormal cells have gone into the surface layer of the skin.

Neither CIN nor VaIN mean that you have cancer, but if left untreated, these abnormal cells are at risk of developing into cancer over a long period of time. A punch biopsy helps you choose the most appropriate care plan option for you.

• You are welcome to have someone with you for support.
• Firstly a colposcopy will be performed to identify the abnormal area.
• Tiny pieces of tissue are removed using an instrument called punch biopsy forceps. This procedure is very quick.
• A solution is applied to the biopsy site to stop any bleeding.
• The whole procedure usually takes around 10 minutes.
• A punch biopsy is normally done without any anaesthetic (numbing). Most patients say that they could not feel the biopsy at all, or could simply feel a small pinch. If you prefer, the colposcopist can inject a local anaesthetic into your cervix. This means you are awake, but the area that needs a biopsy is numb (you cannot feel it). The injection might sting for a short time and you may be aware of your heart beating faster. This feeling should pass within a couple of minutes.

• Punch biopsy is a simple and safe technique.
• There is no effect on your fertility (your ability to conceive).
• It helps the colposcopist to ensure you receive the most suitable follow up care.

Bleeding: There is a small risk of heavy bleeding (for example soaking through a sanitary pad every hour).

Infection: There is a small risk of infection. Symptoms include painful cramps, a high temperature and/or smelly discharge.

You may experience some or none of the following:

• Some abdominal pain is expected for a few hours afterwards. The pain varies from person to person, but is often described as a cramping pain, like a period.
• Some bleeding and discharge. Just after the biopsy you may have light bleeding which turns eventually into a pink or brownish discharge. This could last up to 2 weeks.

If you are concerned that you are bleeding too heavily or have an infection please contact Greenoaks or your GP during weekday working hours, or Ward B11 (open 24 hours a day) on 01709 424349.

Until all bleeding and pink or brownish discharge has stopped it is recommended to avoid:

• penetrative vaginal sex - including fingers, tongues and other objects
• tampons or menstrual cups - you can use pads instead
• heavy exercise that causes you to sweat
• swimming and hot tubs
• baths - you can shower as normal

• Please make sure you eat and drink something before your appointment.
• You will be safe to drive following a punch biopsy, unless advised otherwise by the colposcopist.
• If you have a contraceptive coil, it will not be affected by a punch biopsy.
• Please let your colposcopist know if you have any upcoming holidays, as it may affect your care plan. We may need to delay the punch biopsy until after your return home, because of the risk of bleeding and infection. In addition, some travel insurance companies will not provide you with cover immediately after having a punch biopsy.
• If you are pregnant then we prefer not to do any biopsies on your cervix. We will re-arrange a date, usually 3 months after your baby is born. However, we may suggest a colposcopy during your pregnancy which is not harmful to your baby.
• If you are having your period we can still carry out a punch biopsy if your bleeding is light. Please call the Colposcopy Office or Greenoaks for advice before cancelling your appointment.

Any tissue removed from your cervix or vagina will be sent away for analysis and we aim to write to you within 8 weeks with your results. Please ensure we have your correct contact details. This letter will outline your follow up care.

Appointments

Colposcopy Secretaries

01709 424300
Monday to Friday, 9am to 4pm

Health advice

Greenoaks

01709 427641
Monday to Friday, 9am to 5pm

Further information

Public information from the British Society of Colposcopy and Cervical Pathology (BSCCP)