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How to use the Colposcope?

What is colposcope?

A colposcopy procedure is performed by your healthcare provider as a tool to evaluate your cervix, vagina and/or vulva for abnormal findings. This procedure is routinely recommended to further evaluate abnormal Pap Smear test findings or abnormalities seen during a physical exam. A colposcope is essentially a tool similar to a microscope and allows the exaaminer to enlarge the area being looked at. Colposcopy is also used to further evaluate cervical genital warts, inflammation of the cervix (cervicitis), non-cancerous growths known as polyps, pain, bleeding or to evaluate the cervix following a particular treatment. Additionally, it is used to evaluate the cervix, vulva and the vagina for pre-cancerous lesions or cancer.

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Colposcopy first emerged as a science in the 1920s, when cervical cancer with visible symptoms became more prevalent among young women. It was then that the German physician Hans Hinselmann found an optical magnification system to facilitate the detection of small carcinomatous neoplasms.

In the beginning, he used a Leitz dissection magnifier. He called his technique “colposcopy”, derived from the Ancient Greek words “kolpos” (meaning vagina), and “skopos” (meaning to look at). The suffix “-scopy” may refer to the organ under examination, e.g. vulvoscopy, mamilloscopy, or dermatoscopy.

Colposcopy is an optical micro-inspection procedure to obtain an enlarged image (4x to 40x magnification) of the tissues under examination. Colposcopy is one of the routine diagnostic procedures performed by practical gynaecologists. Indications for a patient to undergo colposcopy include early detection of cancer, early detection of inflammatory and functional pathologies, and postopertive and follow-up controls.
Its stereoscopic visualization capacities make the coloscope also a useful tool for dermatologists in diagnosing skin pathologies.

Hinselmann’s vision to contribute to the early detection of cervical cancer through colspocopy has since come true and meanwhile exceeded his expectations. For decades, colposcopy has been established worldwide and considerably contributed to understanding the formation of cervical cancer.

Since it was revealed that cervical cancer is related to human papillomavirus, the advantages of colposcopy have become obvious. Colposcopic differential diagnosis, performed during dysplasia consultation, by an independent gynaecologist or in the women’s health division of a hospital, allows for the detection and differentiation of the various forms of HPV-related infections, ensuring specific treatment is given.

Colposcopes are often used as a microscope in surgical laser and LEEP procedures.
Tele-colposcopy can be regarded as the latest development, allowing for a live video feed of the examination that can be transmitted worldwide via the internet. Tele-colposcopy enables an expert gynaecologist to monitor the procedure, and facilitates computer-assisted training and education.

How to use the Colposcope?

Colposcopy is conducted with an instrument called a colposcope. This is a low powered microscope that does NOT touch or enter the body. This is a “looking” procedure that allows the doctor to see the cervix and walls of the vagina in much greater detail than would be possible with the naked eye. There is no pain A speculum (the shoehorn type instrument used for most pelvic examinations) is inserted into the vagina. A pap smear may be taken and the cervix is cleansed with a vinegar solution. The colposcope is then used to visualize the cervix and/or the walls of the vaginal. If abnormal areas are seen, biopsies (sample of tissues) are taken for laboratory study. The use of the colposcope in no way affects a women or her childbearing capabilities. It takes approximately ten minutes to complete the examination.

After the examination, the doctor will discuss his findings with you. Laboratory results will be available in about 7 days. You will be contacted by phone for a follow-up office visit to discuss those findings or for corrective treatment.

A colposcopy is an outpatient procedure carried out by a specialist known as a colposcopist, who is usually a doctor or a nurse who has received special training in performing this diagnostic procedure. During the procedure, the patient will be asked to lie down on a special chair with padded leg supports, while a speculum is inserted into the vagina. This device gently opens once inside and allows the practitioner to examine the inside of the cervix with the help of a colposcope, a microscope type device with a light attached to it. This device is used from the outside and does not in any way enter the vagina. Some colposcopes also have a camera attached so images are captured on a monitor in real-time. If there are some abnormal areas, certain solutions may be applied to highlight them. In such cases, the colposcopy is followed by tissue biopsy to confirm the diagnosis. There may be cases, however, where the doctor feels certain about the results of the colposcopy that a biopsy is no longer prescribed; in these cases, the patient will move right on to the treatment process.

There are no preparations required prior to a colposcopy. There is no need to fast and there is usually no need for sedation, as long as a biopsy will not be performed. If a biopsy is required, local or general anesthesia may be needed, and the patient will be asked to refrain from eating for a specific number of hours before the procedure is scheduled to be performed.

The colposcopy may cause some discomfort while the speculum is being inserted and is inside the vagina. If it is followed by a biopsy, the patient will also feel a pinch or scratch when the tissue sample is taken. Although uncomfortable, the procedure is not considered too painful. If a patient finds the procedure too painful, it is best to tell the colposcopist who can prescribe another way to deal with the situation or can decide to stop the colposcopy all together. The whole procedure takes about 10 to 15 minutes, but the entire appointment may take up to 30 minutes including the preparation and the discussion.

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