Colposcopy

Overview

Colposcopy is a way for your medical provider to use a special magnifying device to look at your vulva, vagina, and cervix. If a problem is seen during colposcopy, a small sample of tissue (biopsy) may be taken from the cervix or from inside the opening of the cervix (endocervical canal). The sample is looked at under a microscope by a pathologist.

Colposcopy is usually done to look at the vagina and cervix when the result of a Pap smear is abnormal. Many abnormal Pap smears are caused by viral infections, such as human papillomavirus (HPV) infection, or other types of infection, such as those caused by bacteria, fungi (yeast), or protozoa (Trichomonas). Natural cervical cell changes (atrophic vaginitis) related to menopause can also cause an abnormalPap smear. In some cases, untreated cervical cell changes that cause abnormal Pap smears may progress to precancerous or cancerous changes.

During colposcopy, your medical provider uses a lighted magnifying device that looks like a pair of binoculars (colposcope). The colposcope allows your medical provider to see problems that would be missed by the naked eye.

Your medical provider will put vinegar (acetic acid) and sometimes iodine (Lugol’s solution) on the vagina and cervix with a cotton swab to see problem areas more clearly.

 

 


Why It Is Done

Colposcopy is done to:

  • Look at the cervix for problem areas when a Pap smear was abnormal. If an area of abnormal tissue is found during colposcopy, a cervical biopsy or a biopsy from inside the opening of the cervix (endocervical canal) is usually done.
  • Check a sore or other problem (such as genital warts) found on or around the vagina and cervix.
  • Follow up abnormal areas seen on a previous colposcopy. Colposcopy can also be done to see if treatment for a problem worked.
  • Look at the cervix for problem areas if an HPV test shows a high-risk type of HPV is present.

How To Prepare

Tell your medical provider if you:

  • Are pregnant or might be pregnant. A blood or urine test will be done before the colposcopy to see whether you are pregnant. Colposcopy is safe during pregnancy. If a cervical biopsy is needed during a colposcopy, the chance of any harm to the pregnancy (such as miscarriage) is very small. But you may have more bleeding from the biopsy. A colposcopy may be repeated about 6 weeks after delivery.
  • Are taking any medicines.
  • Are allergic to any medicines.
  • Have had bleeding problems or take blood thinners, such as aspirin or warfarin (Coumadin).
  • Have been treated for a vaginal, cervical, or pelvic infection.

Do not have sexual intercourse or put anything into your vagina for 24 hours before a colposcopy. This includes douches, tampons, and vaginal medicines. You will empty your bladder just before your colposcopy.

You may want to take a pain reliever, such as ibuprofen (Advil or Motrin), 30 to 60 minutes before having a colposcopy. This can help decrease any cramping pain that can be caused by the colposcopy.

Schedule your colposcopy for when you are not having your period. Heavy bleeding makes it harder for your medical provider to see your cervix. The best time to schedule a colposcopy is during the early part of your menstrual cycle, 8 to 12 days after the start of your last menstrual period.

Talk to your medical provider about any concerns you have regarding the need for the colposcopy, its risks, how it will be done, or what the results will mean.


How It Is Done

Colposcopy is usually done by a gynecologist or a nurse practitioner who has been trained to do the test. If a biopsy is done, the sample will be looked at by a pathologist. Colposcopy can be done in your medical provider’s office. You will need undress from the waist down. You will be given a covering to drape around your waist. You will then lie on your back on an examination table with your feet raised and supported by foot rests (stirrups).

Your medical provider will put an instrument with smooth, curved blades (speculum) into your vagina. The speculum gently spreads apart the vaginal walls so your medical provider can see inside the vagina and the cervix.

The colposcope is moved near your vagina and your medical provider looks through the microscope at the vagina and cervix. Vinegar (acetic acid) or iodine (Lugol’s solution) may be used on your cervix to make abnormal areas more visible. If areas of abnormal tissue are found on the cervix, your medical provider will take a small sample (cervical biopsy) of the tissue. Usually several samples are taken. The samples are looked at under a microscope by a pathologist for changes in the cells such as precancerous changes. If bleeding occurs, a special (Monsel’s) liquid or silver nitrate swab may be used on the biopsy area to stop the bleeding.

If a sample of tissue is needed from inside the opening of the cervix (the endocervical canal), a test called endocervical curettage (ECC) will be done. Since the endocervical canal cannot be seen by the colposcope, a small sharp-edged tool called a curette is gently put into the endocervical canal to take a sample. ECC takes several seconds to do and may cause mild cramping. An ECC is not done during pregnancy.

Colposcopy and a cervical biopsy usually take about 15 minutes.

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