Colposcopy, one of the cervical cancer diagnostic tests & bull; hello healthy

Definition

What is a colposcopy?

Colposcopy is a method doctors use using a special magnifying device to view your vulva, vagina, and cervix. If problems are seen during colposcopy, a small sample of tissue will be taken from the cervix or from within the cervical opening (endocervical canal). This sample is viewed under a microscope.

This procedure is usually done to examine the vagina and cervix when the Pap smear test results show abnormal results. Most abnormal pap smear results are caused by a viral infection, such as a human papillomavirus (HPV) infection, or a type of infection, such as those caused by bacteria, fungi (yeast), or protozoa (Trichomonas).

The natural changes in cervical cells (atrophy vaginitis) associated with menopause can also cause abnormal Pap smear test results. In some cases, untreated cervical cell changes can lead to an abnormal Pap smear test and can lead to precancerous or cancerous changes.

During a colposcopy, the doctor will use a bright magnifying device that looks like a pair of binoculars (colposcope). Colposcope allows the doctor to see problems that may not be visible to the naked eye.

A camera will be attached to the colposcope to take pictures or videos of the vagina and cervix.

Your doctor may put vinegar (acetic acid) and sometimes iodine (Lugol's solution) on the vagina and cervix with a cotton ball to see more clearly the problem area.

When should I undergo this procedure?

Colposcopy is done to detect cervical cancer and changes that can cause cervical cancer.

This is most often done when you have an abnormal Pap smear test result. This test is also recommended if you experience bleeding after sexual intercourse.

Colposcopy may also be done if the doctor notices any abnormal parts of your cervix during a pelvic exam. Reporting from WebMD, conditions that are considered abnormal usually include:

• any abnormal growths on the cervix, or other parts of the vagina
• the presence of genital warts or HPV
• irritation or inflammation of the cervix (cervicitis)

Colposcopy can be used to monitor HPV, and to look for abnormal changes that can come back after finishing treatment.

Precautions & warnings

What should I know before undergoing colposcopy?

Colposcopy is not usually used as a screening test for women who are at high risk for cervical cancer. Screening for women at high risk for cervical cancer usually uses a pap smear test.

Even so, a colposcopy can give you and your doctor more information if your pap smear is abnormal.

Colposcopy is often done in conjunction with a cervical cancer biopsy procedure. If the results are both normal, you are less likely to have cell changes that can cause cervical cancer.

Even though the results are normal, you are still advised to do regular pap smear examinations for a certain period of time. Another biopsy may be needed if the results of the pap smear, colposcopy, and cervical biopsy show different results.

Women with human immunodeficiency virus (HIV) have a higher risk of developing cervical cancer. This test is usually recommended for women with HIV and who have abnormal Pap smear results.

Is this procedure painful?

The colposcopy procedure is almost painless. You may feel a little pressure when the speculum is inserted into the vagina.

Also, when the doctor pours in a liquid such as vinegar during the colposcopy process, you may feel a slight stinging or burning sensation.

However, if you were anxious or had excessive fear before the colposcopy, you may feel more pain than those who are able to control their anxiety.

Therefore, it's best to look for activities that help you to be calmer and more relaxed before doing this procedure, such as exercise, meditation, listening to songs, or spending time with the people closest to you.

If you have a colposcopy as part of the biopsy, you may experience some discomfort. Some people describe the pain as resembling menstrual cramps.

After a colposcopy that is done along with a cervical biopsy, you may find spotting, a small amount of blood, or dark colored discharge from your vagina.

Are there any side effects from colposcopy?

Colposcopy procedures are often painless. However, if done in conjunction with a cervical biopsy, you may feel some discomfort, cramping, or even pain in some women — but no more pain than other speculum examinations.

There are no side effects from colposcopy and this test is safe to do even if you are pregnant. However, you are advised to postpone doing this procedure if you are menstruating.

Process

What should I do before undergoing colposcopy?

Schedule a colposcopy the following week after your period. This will make it easier for your doctor to get a clean sample. Discuss the various medications you use with your gynecologist.

Before doing a colposcopy, you may be asked to stop using drugs that can increase the risk of bleeding, such as:

• aspirin
• ibuprofen
• naproxen
• warfarin

Avoid using tampons, douche (vaginal soap), or vaginal cream medication for 24 hours prior to the colposcopy process. During that time, you are advised not to have sexual intercourse.

If this procedure is done in conjunction with a cone biopsy or other form of cervical biopsy that requires general anesthesia (general anesthesia), you will need to fast after midnight, or at least eight hours before the colposcopy procedure begins.

On the scheduled day, your doctor may recommend taking acetaminophen or another pain reliever before coming to the hospital for the procedure.

Prepare several dressings to wear after the colposcopy if there is light bleeding. Ask a family member or friend to drive you home.

How is the colposcopy process?

You will lie on your back on a table with the help of your legs, such as during a pelvic exam or pap smear. When the colposcopy is started, the doctor will place a metal speculum in your vagina.

The speculum holds the vaginal wall open so that the doctor can see your cervix. The doctor will position a special magnifying device, which is called a colposcope , a few inches away from the vulva.

A bright light will be directed into your vagina, and the doctor will look through the lens, as if using binoculars. Your cervix and vagina will be rubbed with cotton to clean from various kinds of mucus.

Your doctor may give you a vinegar solution or other type of solution on the area. This can cause a burning, stinging, or tingling sensation. The solution helps to highlight the parts with suspicious cells.

If your doctor finds a suspicious part, the doctor will likely perform a cervical biopsy at the same time. A small sample of tissue can be taken for testing in the laboratory.

In taking a tissue sample, the doctor uses a sharp biopsy tool to remove a small piece of tissue.

If there are some parts that are suspicious, the doctor will take several biopsy samples. Your doctor may give a chemical solution to the biopsy site to reduce bleeding.

Colposcopy is usually done in a doctor's office, and this procedure usually takes 10-20 minutes.

What should I do after undergoing this procedure?

If this procedure is done in conjunction with a cervical biopsy, you may experience vaginal pain for a day or two. Vaginal bleeding or vaginal discharge is normal for a week after the biopsy.

The discharge may be dark in color if the Monsel solution is used. You can use a bandage during bleeding.

Don't use vaginal soap, have sex, or use tampons for one week, to give your cervix time to heal. Don't exercise for 1 day after your colposcopy.

Follow the directions that your doctor gives you. If you have questions related to this test process, please consult your doctor for a better understanding.

Explanation of the test results

What do the colposcopy and cervical biopsy results mean?

Your doctor can tell you the results of the colposcopy directly during the procedure. However, the biopsy results will usually take several days because they require laboratory tests.

Normal result

• The vinegar or Idonie solution did not show any abnormal parts of the tissue. The vagina and cervix look normal.
• The biopsy sample did not show any abnormal cells.

Abnormal results

• A solution of vinegar or iodine indicates an abnormal patch of tissue. Sores or other problems, such as warts or infections, are found around the vagina or cervix.
• The biopsy sample shows abnormal cells. This indicates the presence of cancer or cancer is likely to develop.