Punch biopsy

Colposcopy has identified an area on your vagina or cervix (neck of the 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 known as ‘cervical intra-epithelial neoplasia’ or CIN. Pre-cancerous changes on the vagina are known as ‘vaginal intra-epithelial neoplasia’ or VaIN. There are three 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 in the future. A punch biopsy helps to decide the most appropriate management option for you.

• Firstly a colposcopy will be performed to identify the abnormal area.
• Small pieces of tissue are removed using an instrument called punch biopsy forceps.
• A solution is applied to the biopsy site to stop any bleeding.
• The whole procedure usually takes around 10 minutes.
• You are welcome to have someone with you for support.
• A punch biopsy is normally performed without any anaesthetic (numbing). Most patients report that they could not feel the biopsy at all, or could simply feel a mild pinching sensation. 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 fertility (the ability to conceive).
• It helps the colposcopist to ensure you receive the most suitable follow up.

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. Initially there may be light bleeding which turns eventually into a pink/ 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 out of hours on 01709 424349.

Until all bleeding/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 advise your colposcopist of 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 following 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 three 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 provided that 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 the 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 4pm