Definition Colposcopy involves the use of a special lighted microscope to magnify the surface of the cervix during a pelvic examination. The cervix is the lowest part of the uterus and contains the opening from the uterus to the vagina.
Who is a candidate for the procedure? A colposcopy may be used in combination with a cervical biopsy to detect cancer of the cervix or precancerous changes known as cervical dysplasia. A cervical biopsy is usually done after a woman has abnormal results from a Pap smear that is done as part of a pelvic examination. A Pap smear is a test in which the doctor uses a small spatula and a brush to gently scrape cells from the woman's cervix. These cells are sent to a laboratory for testing. The Pap smear may show early, abnormal, cancer-like changes in the cells of the cervix.
A woman should have a colposcopy, as well as a cervical biopsy, if the following conditions apply:
She has extensive genital warts on her vulva, which are the lips at the opening of the vagina
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She was exposed to DES in her mother's uterus. Diethylstilbestrol, a potent medication to prevent miscarriages, has been associated with abnormal changes in the cervix of women exposed to DES while they were foetuses.
She has had one abnormal Pap smear that suggested moderately abnormal tissue growth or more severely abnormal cells
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How is the procedure performed? A colposcopy is done with the woman lying on her back with her feet in stirrups. The doctor places a speculum inside the woman's vagina. This instrument helps enlarge the opening of the vagina, which allows the doctor to see the cervix and vaginal interior.
The doctor uses the colposcope to magnify and examine the cervix and vagina. To make cells more visible under the colposcope, the doctor puts a mild solution of vinegar on the area. Sometimes the doctor also uses a solution of weak iodine.
If a cervical biopsy is being done at the same time as the colposcopy, the doctor takes small bits of tissue, or a biopsy, from suspicious areas. The technique is called cervical punch biopsy. The woman may feel a brief pinch or cramp. The doctor records the location of the abnormal areas and sends the tissue sample or samples to a laboratory to be viewed under a microscope.
What happens right after the procedure? Cramping usually passes within minutes of the colposcopy. If she sits up too quickly, a woman may feel lightheaded. Lying down for a few minutes after the procedure prevents this. Any further cramping may be treated with an over-the-counter analgesics, such as paracetamol or ibuprofen.
If a biopsy was also done, the biopsy samples are sent to the laboratory to be examined under the microscope by the pathologist. The doctor discusses the pathologist's findings with the woman. Abnormalities can range from mild cervical dysplasia, or slightly abnormal changes in the cells examined, to cancer of the cervix. Treatments and follow-up depend upon the exact diagnosis.
What happens later at home? For 1 to 2 days after a colposcopy and cervical biopsy, a woman may have a small amount of pinkish discharge from the vagina. For 2 to 3 days afterward, she should avoid sexual intercourse, douches, and tampon use.
What are the potential complications after the procedure? A woman may experience minor bleeding after a colposcopy and cervical biopsy. Other potential complications include heavier vaginal bleeding, infection, or allergic reaction to the iodine used in the procedure. Any new or worsening symptoms should be reported to the doctor.
Author: Reviewer: HealthAnswers Australia Medical Review Panel Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia Last Updated: 1/10/2001 Contributors Potential conflict of interest information for reviewers available on request
