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Colposcopy

What is colposcopy?

Colposcopy is a common office procedure and is performed by your medical provider to evaluate abnormal pap tests and visible changes of the vagina and cervix.  Colposcopy also is occasionally performed to eval­uate lesions on the vulva.

The cervix has 2 different kinds of cells that line it. There is a smooth lining (squamous epithelium) that covers the face of the cer­vix, and a glandular lining (columnar epithe­lium) that lines the canal of the cervix. The junction of these 2 cell types is the metaboli­cally active part of the cervix where abnor­malities arise. During the colposcopy, your doctor will try to visualize this entire junc­tion.

The colposcope is a special microscope on wheels that allows the provider to magnify and illuminate the vagina and cervix. Abnormal areas seen with the colposcope are sampled by taking biopsies (small snips of tissue). The biopsied tissue is sent to a pathologist who examines the biopsies microscopically in order to make a defini­tive diagnosis.

Why has my provider recommended colposcopy?

Your provider recommended that you have a colposcopy if you had an abnormal Pap test, an abnormal HPV test, or if there was a visible abnormality on your cervix.  

Is there anything I should do before the procedure?

Be sure to schedule the colposcopy appointment on a day when you’re not having your menstrual peri­od. In preparation for the procedure, avoid sexual intercourse and do not use any medications in your vagina in the 24 hours before your appointment. 

Eat normally the day of your appointment.  One hour before your appointment take 600 mg of ibu­profen  (3 tablets of 200 mg over the counter strength) along with some food.

What will happen during the procedure?

You will lie on an examination table, just as you would for a Pap test. Your provider will insert a speculum into the vagina to hold it open. Then, a vinegar solution will be applied to the cervix to make the abnormal areas more visible.  You may feel a slight burning at this time.  Next, your provider will look through the colposcope, to examine the cer­vix. Small samples (biopsies) will be taken of any abnormal areas.   The provider may also take a sample from the cervical canal called an endocervical curettage.  Topical medication will be applied to the biopsy site to reduce the bleeding.

Will it hurt?

When biopsies are taken, most women experi­ence a deep, menstrual– like cramp that fades quickly. Your provider  will ask you to take slow, deep breaths or to cough as the biopsies are taken to lessen any discomfort. Cervical biopsies take several seconds to obtain. The endocervical curettage takes about 30 seconds. Most women are pain free when they leave the office.

How much time will a colposcopy take?

The actual procedure takes between 15 to 30 minutes, but allow for an hour or so in the office.

How will I feel following a colposcopy?

After the procedure, you may experience mild cramping from the biopsy which can last for several hours. Spotting or light bleeding can persist for 3-5 days.  You may also have some discharge for the next several days from the solutions applied during the procedure.

When can I resume my regular schedule?

It is best to avoid sexual intercourse and tampons for several days following a colposcopy procedure if biop­sies are taken. Most women feel comfortable resum­ing normal activities the same day as the colposcopy.

Is colposcopy safe?

Colposcopy is a safe procedure.  Very occasionally, someone will experience nausea or fainting during the procedure (about as often as this happens with draw­ing blood.)  Complications afterwards are unusual, but can include heavy bleeding, infection or ongoing pain. Please return to the office immediately if you experience heavy bleeding, lower abdominal pain with fever or abnormal discharge, or cramping not relieved by ibuprofen.  

What is the next step?

Your medical provider will arrange a follow-up visit to discuss the results of the biopsy and a further plan of manage­ment.

If you have additional questions after reading this, please call 812-855-7558.