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What is colposcope ?

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A colposcope is a special type of microscope, which allows the doctor to examine the tissues of the cervix, vagina and vulva more clearly by magnification.

Colposcopy is a procedure which allows the cervix (the neck of the womb) to be examined, using a device called a colposcope, which illuminates and magnifies the area. The procedure is actually similar to that of a cervical smear, however it takes longer, as the colposcopy looks for any abnormalities through the application of various solutions to the cervix. Colposcopes can also be used to examine the vagina and vulva.

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An abnormal or positive smear test very rarely means that you have cancer. After this; you may be referred for a colposcopy examination so that the colposcopist can look at your neck of womb (cervix), identify any potential threat and treat it. This test is most often done when the result of a Pap test is abnormal. Most abnormal Pap tests are caused by viral infections. Examples are HPV infection and other types of infection, such as those caused by bacteria, fungi, or protozoa.

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.

What is colposcopy-I was just wondering what a colposcopy is? Something irregular turned up on my pap smear. My gynecologist gave me sulfa-based creams, but the irregularity on the cells from my cervix was still there on my next exam. Now, I have to have a colposcopy, and I was wondering what that entails. My doctor said that it was just to see if further action needed to be taken. Could you tell me, if at all possible, what purpose colposcopies serve and what is wrong with the cells? In other words, do you have any idea, from a vague description, what could be wrong? Thanks.

Colposcopy allows your doctor to get a good look at what’s going on among your cervical cells. It involves using a colposcope, an instrument that magnifies the area 10 to 20 times, and a staining solution, which makes it easier to distinguish between the healthy, normal cells and the atypical cells. If any questionable areas of atypical growth are obvious, they can be biopsied in order to determine the extent of the problem, and to decide on a course of treatment, if any is needed. A colposcopy isn’t much more uncomfortable than a gynecological exam, though some people experience some discomfort or cramping from the procedure. It takes less than an hour, can be done in your doctor’s office, and doesn’t require any anesthesia.

The part of the cervix exposed to the vagina is a very active site for cell growth. Pap smears indicate whether cell growth is healthy and normal, or if it has changed in any way. Of course, abnormalities of cell growth can be of varying degrees of severity. Thus, when your Pap smear results indicate some irregularity, it can mean a few things.

The most common explanation for irregular Pap smear results is “atypical” cells. This is not cancer — it simply means that some of the cells began growing in an aberrant fashion. Or, you could possibly have a somewhat more serious condition called dysplasia, or cervical intraepithelial neoplasia (CIN). For more information on what dysplasia and atypical cells involve, you can read What is dysplasia?.

In either case, atypical cells or dysplasia, treatment involving antibiotic sulfa-based creams is unnecessary and ineffective. Usually, you can wait a few months to see if the abnormality resolves on its own. However, if your next Pap smear also comes back “irregular,” then you’ll want to have a more accurate and thorough diagnostic test done. That’s basically what a colposcopy is.

It can be scary to receive abnormal test results, of any kind. Hopefully, knowing more about it will ease some of your concerns. Whether you’re seeing a health care provider at Columbia or elswhere, you can ask your provider for more information sheet on colposcopies. The Mayo Clinic site (link is external) is also a great resource for learning more about the procedure.

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What is colposcopy,how colposcopy work?

How colposcopy procedure works?

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.

If your gynecologist has scheduled you for a colposcopy, it’s likely because something looked not-quite-right during your last appointment, usually an abnormal Pap smear or HPV test — but before you start worrying, keep reading.

Does a colposcopy mean something is wrong?

Your doc (not the internet) is the best option when it comes to answering questions about your personal health. But, long answer short, no — it doesn’t necessarily mean something is wrong. Your doctor could have scheduled it because of an abnormal Pap or HPV test. It’s also possible that your cervix looked abnormal during your last gynecological exam or that you’re having issues like abnormal bleeding. A colposcopy is simply an easy way for your doctor to get a closer look at your cervix and figure out what’s going on.

What happens during the procedure?

A colposcopy is a quick outpatient procedure usually done in your gyno’s regular exam room. Your doctor will use a speculum to hold apart the vaginal walls and then place a colposcope — a binocular-like instrument — just outside the vaginal opening. She’ll also use a cotton swab or ball to apply a liquid solution to the cervix and vagina that makes it easier to see abnormal cells. Don’t worry, the colposcope stays outside the body throughout the procedure, so this part of the procedure is no more uncomfortable than a regular exam. If the doctor spots abnormal cells, a biopsy will be performed to collect a small sample of tissue for testing.

Does it hurt?

The level of discomfort or pain you might feel during a biopsy will depend on what type of tissue is being removed — a biopsy of the lower portion of the vagina or the vulva can cause some pain (your doc may use local anesthetic), but since the vagina doesn’t have that many nerve endings, it’s possible the procedure will be pain-free. During a cervical biopsy, you may just feel some pressure or cramping. For most women, even the painful parts just feel like a sharp pinch, but speak up if you’re worried — your doctor should do whatever possible to help make the procedure more comfortable for you. And don’t worry, the appointment will be pretty quick — altogether, the colposcopy and biopsy only take about 10-20 minutes.

What’s next?

Check with your doctor — you likely won’t experience anything more uncomfortable than a little light spotting for a few days if you didn’t have a biopsy. If you did, it’s possible you’ll have a little pain, bleeding, or dark discharge. You gynecologist may suggest you abstain from having vaginal sex or using tampons for a few days.

What happens once the results are in?

Your doctor will put together a plan for you, but your follow up care can be as simple as a repeat Pap to check to see if your abnormal cells have healed. Sometimes the biopsy itself can take care of issues, if your doctor removed the abnormal cells during the procedure. If abnormal cells are still a concern, your doctor may recommend cryotherapy to freeze off the abnormal tissue, a laser treatment, a cone biopsy to cut a cone-shaped wedge out of the cervix, or a LEEP (aka loop electrosurgical excision procedure), which removes abnormal tissue with a thin wire carrying an electrical current.

What is Possible risks and complications?

As with any procedure, there are risks. Although rare, some risks include heavy bleeding, pelvic pain and/or infection from the biopsies taken during the colposcopy. Notify your healthcare provider immediately if you experience heavy vaginal bleeding in which you are saturating a pad every hour, severe lower abdominal pain, fever or chills.

As a diagnostic procedure, a colposcopy is not considered a surgery and is generally safe. However, there is still a risk of some complications; this risk is greater if the colposcopy is followed by a biopsy. The most common risks involved are:

Bleeding
Infection
Allergic reaction to the substances used during the test
Sensitivity to medications or anaesthetics

Some factors may also affect the results of or interfere with a colposcopy. These include:

Acute cervical inflammation
Acute pelvic inflammatory disease
Menstruation

To ensure accurate results and lessen the risk of complications, a colposcopy is best performed approximately one week after a patient’s menstrual period.

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The most common reasons why colposcopy is performed include:

The presence of abnormal cells as confirmed by a cervical screening sample, regardless if these cells are cancerous or not
The patient is diagnosed with human papillomavirus or HPV, a leading cause of abnormal cell changes leading to cervical cancer
Inconclusive cervical screening tests
Certain symptoms raising suspicions of an unhealthy cervix, including vaginal bleeding and cervical inflammation

The colposcopist will be able to tell right away if there are abnormalities, so there is no need to wait for the results of the test. However, if a biopsy is performed after the colposcopy, the results may take about four weeks. Based on statistics, 40% of patients who were required to undergo colposcopy obtained abnormal results. However, an abnormal result does not necessarily mean that the patient has cervical cancer, but the presence of the abnormal cells point to an increased risk of cancer especially if the abnormality is not treated right away. A colposcopy, however, may be able to diagnose a cervical cancer; in such cases, the patient is quickly referred to a cancer specialist.

Normal results mean that the cervix is healthy and the patient has a low risk of developing cervical cancer. Regardless of the results, women are encouraged to undergo cervical screening test every three to five years as a preventative measure.

Been told you need a colposcopy? That’s good! Colposcopy is a really good way of getting more information which may help prevent serious gynaecological conditions. Think of it as being an early warning system or part of a comprehensive plan for excellence in women’s health. It may feel a bit undignified (like most gynaecological procedures) but it is not recommended unnecessarily. If it has been recommended that you have a colposcopy, don’t put your head in the sand, just come and see us at Clinic 66. We will make it as hassle free as possible. Colposcopy involves using a powerful microscope to take a really close look at the cervix. This is because there may be some abnormalities which cannot be seen with the naked eye. Colposcopy is usually used to look at the cervix after an abnormal pap smear but can be used to check anything unusual around the vulva or in the vagina.

Women who have had unexplained bleeding after sex or in-between periods may be recommended to have a colposcopy. This is because there may be treatable abnormalities in the cervix such as pre cancerous changes.

Having an abnormal pap smear/test doesn’t mean that a woman has cancer, however colposcopy may be recommended in order to exclude a sinister cause for the abnormality. The gynaecologist may use acetic acid or Lugols solution (iodine) to help certain cells stand out more under the colposcope. It is common for a biopsy to be taken during colposcopy i.e. a tiny fragment of tissue removed and sent to the lab for further analysis. This is because a pap smear is not accurate enough to determine what, if any, treatment is required.

Colposcopy may also be used as a checking test, for instance after pre cancerous cells have been removed, and thus making sure that the treatment was successful.

Colposcopy can easily be performed as an awake procedure as it’s like having a pap test though you’ll be examined by the doctor, for a longer time. Or, if you prefer, at Clinic 66, you can have a colposcopy under sedation (light anaesthetic) so you can feel very relaxed and comfortable.

If you have been told that you should have a colposcopy, you can ring and refer yourself today to Clinic 66, or get your GP to refer you with a letter.

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