Colposcopy

Your healthcare provider uses
colposcopy to view the opening to the uterus, called the cervix, and the vagina. It uses
an instrument with a magnifying lens and a light, called a colposcope. It magnifies the
image many times. The healthcare provider sees the tissues on the cervix and vaginal
walls more clearly. In some cases, your provider will take a small sample of tissue for
exam in the lab. This is called a cervical biopsy.

Your provider may do a colposcopy
if he or she finds problems or abnormal cells during a pelvic exam or Pap test. Through
the colposcope, the healthcare provider can see certain changes in cervical and vaginal
tissues. These include abnormal blood vessels, tissue structure, color, and patterns.
Your provider may call cells that look abnormal, but are not yet cancerous
“precancerous.” These abnormal cells may be the first signs of cancer that develops
years later.

If your provider sees abnormal
tissue during a colposcopy, he or she may take a small sample of tissue for further
study. The healthcare provider may also take tissue samples from inside the cervix.

Your provider may use colposcopy to
diagnose and assist in the treatment of:

  • Bleeding
  • Polyps (noncancerous growths)
  • Genital warts, which may suggest
    infection with human
    papillomavirus
    (HPV), a risk factor for developing cervical cancer
  • Diethylstilbestrol (DES) exposure in
    women whose mothers took DES during pregnancy, as DES exposure raises the risk for
    cancer of the reproductive system

Your healthcare provider may have
other reasons to recommend colposcopy.

Possible complications of biopsy
may include:

  • Infection
  • Bleeding

If you are allergic to or sensitive
to medicines, iodine, or latex, tell your healthcare provider.

If you are pregnant or think you
could be, tell your healthcare provider.

If possible, schedule your
colposcopy about a week after your period.

There may be other risks based on
your condition. Be sure to discuss any concerns with your healthcare provider before the
procedure.

Certain factors or conditions may
interfere with a colposcopy. These factors include:

  • Having your period
  • Acute pelvic inflammatory disease
  • Acute inflammation of the cervix
  • Your healthcare provider will explain
    the procedure and you can ask questions.
  • You may be asked to sign a consent
    form that gives your permission to do the procedure. Read the form carefully and ask
    questions if something is not clear.
  • Generally, you don’t need any
    preparation, such as fasting or sedation. If you have a biopsy under regional or
    general anesthesia, you may need to fast for a certain number of hours before the
    procedure, generally after midnight.
  • If you are pregnant or think you could
    be, tell your healthcare provider.
  • Tell your healthcare provider if you
    are sensitive to or are allergic to any medicines, latex, tape, iodine, and
    anesthesia.
  • Tell your healthcare provider of all
    medicines (prescribed and over-the-counter) and herbal supplements that you are
    taking.
  • Tell your healthcare provider if you
    have a history of bleeding disorders or if you are taking any blood-thinning medicine
    (anticoagulants), aspirin, or other medicines that affect blood clotting. You may be
    told to stop these medicines before the procedure.
  • Don’t use tampons, vaginal creams or
    medicines, douche, or have sex for 24 hours before the test.
  • Your healthcare provider may advise
    that you take a pain reliever 30 minutes before the procedure. He or she may give
    you a sedative before the anesthesia is started. If sedation is given, you will need
    someone to drive you home afterwards.
  • You may want to bring a sanitary pad
    to wear home after the procedure.
  • Based on your condition,
    your healthcare provider may request other preparation.

You may have a colposcopy in your
healthcare provider’s office or during a hospital stay. Procedures may vary based on
your condition and your healthcare provider’s practices.

Generally, a colposcopy follows
this process:

  1. You will need to undress completely or
    from the waist down and put on a hospital gown.
  2. You will empty your bladder before the
    procedure.
  3. You will lie on an exam table, with
    your feet and legs supported as for a pelvic exam.
  4. Your healthcare provider will insert
    an instrument called a speculum into your vagina to spread the walls of the vagina
    apart to expose the cervix.
  5. He or she will place the colposcope,
    which is like a microscope with a light on the end, at the opening of your vagina. It
    doesn’t enter your vagina.
  6. Your healthcare provider will look
    through the colposcope to look for any problems on the cervix or in the vagina.
  7. Your provider may clean and soak your
    cervix with a vinegar solution, also called an acetic acid solution. This solution
    helps make the abnormal tissues turn white and become more visible. You may feel a
    mild burning sensation. An iodine solution may be used to coat the cervix, called the
    Schiller test.
  8. Your healthcare provider may take a
    small tissue sample called a biopsy. When this is done, the area is numbed, but you
    may feel a slight pinch or cramp as the tissue is removed.
  9. Your provider may take a sample of
    cells from the inside of the cervical canal. This may also cause some cramping.
  10. Your provider may use a paste-like
    topical medicine or pressure dressing to treat bleeding from the biopsy site.
  11. The tissue will be sent to a lab for
    testing.

After a colposcopy, you may rest
for a few minutes before going home.

If you have a colposcopy with a
biopsy, the recovery process will vary. It will depend on the type of biopsy done and
the type of anesthesia (if any) used.

If you have anesthesia, you will be
taken to the recovery room for observation. Once your blood pressure, pulse, and
breathing are stable and you are alert, you will be taken to your hospital room or
discharged home. If you have this procedure on an outpatient basis, plan to have
someone drive you home.

You may want to wear a sanitary pad
for bleeding. If you have a biopsy, it is normal to have some mild cramping, spotting,
and dark or black-colored discharge for several days. The dark discharge is from the
medicine applied to your cervix to control bleeding.

If you had a biopsy, don’t douche,
use tampons, or have sex for one week after the procedure, or for as long as your
healthcare provider advises.

You may also have other limits on
your activity, including no strenuous activity or heavy lifting.

You may go back to your normal diet
unless your healthcare provider tells you otherwise.

Take a pain reliever for cramping
or soreness as directed by your healthcare provider. Aspirin or certain other pain
medicines may increase the chance of bleeding. Be sure to take only recommended
medicines.

Your healthcare provider will tell
you when to return for further treatment or care. Generally, women who have had a
cervical biopsy will need Pap tests more often.

Tell your healthcare provider if
you have any of the following:

  • Bleeding
  • Foul-smelling drainage from your
    vagina
  • Fever or chills
  • Severe pelvic (lower abdominal)
    pain

Your healthcare provider may give
you other instructions after the procedure, depending on your situation.

Before you agree to the test or the procedure make sure you know:

  • The name of the test or procedure
  • The reason you are having the test or
    procedure
  • What results to expect and what they
    mean
  • The risks and benefits of the test or
    procedure
  • What the possible side effects or
    complications are
  • When and where you are to have the
    test or procedure
  • Who will do the test or procedure and
    what that person’s qualifications are
  • What would happen if you did not have
    the test or procedure
  • Any alternative tests or procedures to
    think about
  • When and how will you get the
    results
  • Who to call after the test or
    procedure if you have questions or problems
  • How much will you have to pay for the
    test or procedure