Providing a genitourinary medicine colposcopy service

Area of Science:

• Gynecology
• Genitourinary Medicine
• Colposcopy

Background:

• Historically, Genitourinary (GU) Medicine managed abnormal cervical cytology, including colposcopy.
• Introduction of colposcopy certification in 1998 led most GU Medicine clinicians to discontinue the service.
• A need arose for colposcopy services in GU Medicine for conditions like post-coital bleeding (PCB).

Purpose of the Study:

• To review the effectiveness and appropriateness of a GU Medicine-based colposcopy service for young women presenting with PCB.
• To assess clinical findings and management of patients referred to GU Medicine for PCB.

Main Methods:

• A case note review of 357 consecutive patients referred to GU Medicine for PCB (with or without intermenstrual bleeding, IMB) under age 40.
• Evaluation of clinical findings, management, and referral appropriateness.

Main Results:

• Cervical pathology was uncommon in the studied population.
• The conditions identified were generally easily treatable within the GU Medicine setting.
• GU Medicine nurse practitioners or doctors can provide colposcopy services with appropriate training.

Conclusions:

• Referral to GU Medicine for PCB in women under 40 is an appropriate pathway.
• Colposcopy skills acquired for cervical assessment are transferable to other ano-genital examinations.
• Establishing colposcopy services within GU Medicine is feasible and beneficial.