Colposcopy

Colposcopy is a procedure performed by a physician using a special magnifying device to look at a woman’s cervix, vulva and vagina.  The practitioner uses a colposcope, which is a lighted magnifying device that looks like a pair of binoculars. The colposcope, by enlarging the view from 2 to 60 times its normal size, allows the physician to see problems that would be missed by the naked eye.

Pap Tests and Problems

Colposcopies are most often performed when a Pap test shows changes in the cells of the cervix (the lower, narrow end of the uterus) that could lead to cancer.  This area continually grows and sheds cells, but sometimes this process changes and the cells become abnormal.  In some cases, these abnormal cells can lead to cervical cancer, and the Pap test is the best method available for early detection of these changes.  The colposcopy is usually performed as a precaution since only about 2% of abnormal Pap tests are a result of cervical cancer.

An abnormal Pap test does not mean cancer or even precancer is present.  Abnormal Pap tests can also be caused by viral infections, such as human papillomavirus (HPV) infection, or other types of infection, such as those caused by bacteria or yeast.  Other times, natural cervical cell changes related to menopause can also cause an abnormal Pap test.   

Colposcopies are performed for other reasons, too.  Among them are:

• To look at sores or genital warts found on or around the vagina and cervix.
• To look for the cause if a woman is experiencing pain and/or abnormal bleeding.
• To look at the cervix for problem areas if an HPV test shows a high-risk type of HPV is present.
• To check for polyps, which are noncancerous growths that sometimes develop from the tissue lining the inside of the uterus.
• As a follow-up, to check the result of a previous treatment.

Preparing for a Colposcopy

As with any procedure, your healthcare provider needs to know certain information ahead of time.  For example, if you:

• Are taking any medicines
• Are allergic to any medicines
• Have had bleeding problems in the past, or are currently taking blood-thinning medications such as aspirin, Coumadin or heparin
• Have been treated in the past for a vaginal, cervical, or pelvic infection
• You will probably be advised not to have sexual relations, use tampons, douche, or use vaginal medications for at least 24 hours before the procedure.

The Colposcopy

Colposcopy is usually done by a physician who has been trained to do the test.   It can be done in your practitioner’s office.
You will be asked to take off your clothes below the waist, and 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, or stirrups.

The physician will put an instrument with smooth, curved blades, called a speculum, into your vagina.  The speculum gently spreads apart the vaginal walls so your doctor can see inside the vagina and the cervix. The colposcope is moved near your vagina so that the physician/midwife can look through the microscope at the vagina and cervix.  A mild solution, such as vinegar and water, will be applied to those areas with a cotton swab to make abnormal areas more visible. This can sometimes result in a slight burning sensation, but it is perfectly harmless. 

If areas of abnormal tissue are found on the cervix, the physician will take one or more small samples (biopsies) of the tissue. The samples are looked at under a microscope for changes in the cells that may mean cancer could be present or is likely to develop.

After the Procedure

It usually takes several days for the results of a biopsy to come back from the lab. You are welcome to call our office for results 7-10 days after the procedure.
If no biopsy was taken, you may have minor spotting for a few days but you can return to your normal life. If a biopsy was done, you may feel some soreness in your vagina for a day or two. Some vaginal bleeding or discharge is normal for up to a week after a biopsy. Do not douche, have sex, or use tampons for one week, to allow time for your cervix to heal.  Do not exercise for one day after your colposcopy.

Also, it is important that you call your healthcare provider immediately if you have:

• Vaginal bleeding that is heavier than a normal menstrual period
• A  vaginal discharge with a bad odor
• A fever, chills or lower abdominal pain

Remember

Colposcopy is a safe and relatively quick procedure used by physicians that provides a magnified and illuminated view of the vulva, vaginal walls, and uterine cervix.  This procedure is often done to assist your healthcare provider in evaluating an abnormal appearing cervix or an abnormal Pap test result. 
If you would like to see a video of a colposcopy, you can do so at the following website: http://video.about.com/womenshealth/Colposcopy-Exam.htm