Colposcopy

A colposcopy-directed biopsy uses a colposcope  to aid in the viewing of the surface of the cervix. A colposcope is a low-power microscope that magnifies the surface of the cervix 10 to 40 times its normal size. It helps detect areas on the surface that show abnormalities of any kind.

You will have to lie on a table and place your feet in stirrups to station your pelvis for examination. A speculum will be inserted into your vagina and opened slightly. A speculum is an instrument used to hold open the vaginal canal in order to observe and examine the cervix.

The cervix is then swabbed with a chemical solution (acetic acid) to eliminate the mucus that covers the surface, and to highlight abnormal areas. The colposcope is then positioned at the opening of the vagina, and the area is thoroughly examined. Photographs may be taken.

If any areas look abnormal, a small sample of the tissue will be detached (biopsy) using small biopsy forceps. Many samples may be taken, depending on the size of the area. There is no special preparation. You may be more comfortable if you empty your bladder and bowel before the procedure begins. You should not douche or have sexual intercourse for 24 hours before the exam.

A colposcopy is painless. Some women feel a minor stinging sensation caused by the vinegar solution. The biopsy may feel like a pinch each time a tissue sample is taken, which may cause some cramping.

Any pain, discomfort or cramping you feel during the biopsy may be eased by relaxing and taking a couple of slow deep breaths. Some cramping and discomfort may occur after the biopsy. It is common for a woman to hold her breath during pelvic procedures in anticipation of pain. Making a mental effort to concentrate on slow, regular breathing will help you relax and decrease or eliminate some pain. This procedure is commonly performed after a positive pap smear to identify the abnormality. A smooth, pink surface of the cervix is normal. A biopsy is only performed when abnormal tissues are seen or suspected because of abnormal Pap smear outcome.

Abnormalities detected involve cervical warts (human papilloma virus), precancerous tissue changes, cervical intraepithelial neoplasia, or invasive carcinoma (cancer). The colposcopy may be used to keep track of precancerous abnormalities and look for recurrent abnormalities after treatment.

Abnormal findings during a colposcopy test involve abnormal patterns in the blood vessels, whitish patches on the cervix, and areas that are inflamed, swollen, eroded, or atrophic (tissue wasting away). Any of these abnormalities may signify cancerous changes.

Additional conditions under which the colposcopy test may be performed involve cervical dysplasia (indicated by abnormal Pap smear) After the biopsy, there may be some bleeding for up to a week. Avoid sexual intercourse, douching, and using tampons for at least two weeks to permit the biopsy area to heal.

If bleeding is unusually severe or lasts for longer than 2 weeks, or if you observe any signs of infection (fever, foul smell, or discharge), inform your health care provider as soon as possible. If the colposcopic examination or biopsy does not show why the Pap smear was abnormal, a more extensive biopsy may be needed.