What is Colposcopy?

 

Colposcopy is the examination of a woman's cervix with a special microscope called a colposcope. Colposcopy is performed in office to evaluate an abnormal PAP smear, or to examine for abnormal growths in the woman's genital tract inside or on the outside of the vagina. The PAP smear is a good screening test, but may not accurately predict the extent of disease on the cervix. Colposcopy is a more accurate diagnostic test.

What Preparation is Needed Before Colposcopy?

We recommend that you take 3 or 4 Advil (ibuprofen) tablets with some food about an hour before your procedure. This will reduce cramping associated with the procedure. You also will be asked to complete some paperwork before your physician talks with you about the procedure. The entire visit generally takes about 30 minutes.

How is Colposcopy Performed?

Your feet will be placed in stirrups, as when having a PAP smear performed. Some vinegar will be placed on the outside and inside of your vagina. Vinegar can cause a mild burning sensation, but will not harm you. The colposcope is used to examine the tissues. A speculum is used to visualize the cervix. If the cervix appears normal, your physician may choose to perform a repeat PAP smear.

If the cervical tissues stain white, then your physician will perform a scraping and biopsies. The scraping is called endocervical curettage, and it is performed to evaluate the cells on the inside of the cervical canal. The scraping is only performed in the cervix, and not up inside the uterus. If the cells of the uterus must be examined, your physician will ask permission to perform another test called an endometrial biopsy. The endocervical curettage does not tear or cut the cervix, but it can be uncomfortable because the procedure makes the uterus cramp. The Advil you take before the procedure should help with the cramping. The endocervical curettage only takes 10 to 15 seconds to perform. Your physician then will perform biopsies, or the removal of tiny bites of tissue. The biopsies generally are not painful, but your physician may choose to spray some numbing medicine onto the cervix to help. A brown solution is then applied to the cervix to stop any bleeding at the biopsy sites. This brown solution contains iron, and will produce a brown discharge for a few days following the procedure.

What Happens After the Procedure?

The next step depends upon the biopsy results. Your physician may request that you return to the office in one month's time. If your biopsies are normal or only mildly abnormal, your physician will discuss the proper follow up for you for the next year. If more severe abnormalities are noted, your cervix may need treatment that we often can perform in the office. Either way, It is very important that you follow your physician's recommendations so that you do not develop more severe disease or cancer.

What Should I do After the Procedure?

If you have any cramping, you can take ibuprofen (Advil) or acetaminophen (Tylenol). You may want to wear a pad for a few days to prevent staining of your underwear by the iron solution. Do not place anything in the vagina for one to two weeks. Intercourse can be safely resumed two weeks after the procedure. Call the office if you have any heavy bleeding, fever, or foul smelling discharge. No time off from work is generally needed. Your physician may recommend multivitamins to help the cervix to heal. Smokers should discontinue smoking.

Abnormal PAP Treatment

If your last PAP Smear has been reported "abnormal," sometimes a follow-up procedure is recommended.. A colposcopy is a test done to find out what types of cells are abnormal and where they are. Using a colposcope, a medical practitioner can take a biopsy (tissue sample), which significantly improves accuracy of diagnosis.

Why is a woman advised to have an exam with a colposcope?

If the cervix looks abnormal or if a PAP smear indicates the presence of abnormal cells, colposcopy may help in diagnosis and in planning of treatment. It may be difficult to find out the condition of the cervix by simply looking with the naked eye. A magnified view may clarify abnormalities, and, if found, a colposcopic exam can be used to decide from which areas a biopsy should be taken.

What are a colposcope and a colposcopy?

A colposcope is a low power microscope used to look at the cervix and vagina under magnification. A colposcopy is a painless examination of the cervix and vagina with a colposcope. This exam usually is done between menstrual periods and generally takes less than ten minutes. A woman lies down in the position used to take a PAP smear and a speculum is inserted into the vagina to give a view of the cervix and vagina.

What is a biopsy of the cervix, and is it painful?

Biopsy is the removal of a small piece of tissue from the cervix using a specially designed instrument. One or more biopsies may be necessary during your colposcopy. Most women describe the procedure as feeling like a sharp pinch.

What treatment will I need?

The treatment will depend on the results of the colposcopy. All treatment options will be discussed with you, and appropriate follow-up planned