Introduction
Colposcopy is a procedure to closely examine the cervix, vulva, and vagina for signs of disease. A specialized instrument called a colposcopy is used during colposcopy, which provides an alighted, highly magnified view of the tissues. A colposcopy is usually done if the results of the pap test are abnormal. Any abnormal tissue found during the colposcopy procedure is collected and sent to the laboratory for examination. It is also used for other health conditions, such as noncancerous growths called polyps or genital warts.
Why Is Colposcopy Performed?
A doctor will recommend a colposcopy when the results of a pap smear show abnormal cell activity or growth. The colposcope provides a closer look at the cervix and helps determine why the cells are abnormal. A doctor may also use colposcopy in some cases where a close examination of the cervix is required.
Reasons for performing a colposcopy include:
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Presence of genital warts
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Cervicitis, or an inflamed cervix
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Abdominal pain.
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Abnormal bleeding.
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Polyps like benign growths on the cervix.
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Checking results of any treatment.
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Infected with human papillomavirus (HPV), which is the main cause of abnormal cell changes.
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After several screening tests, it was impossible to give a proper result.
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Precancerous changes in the tissue of the cervix.
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Precancerous changes in the tissue of the vagina.
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Precancerous changes of the vulva.
How to Prepare for a Colposcopy Procedure?
To prepare a for colposcopy, here are few tips:
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Avoid scheduling the colposcopy during the menstrual cycle.
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Do not have vaginal intercourse the day or two before the colposcopy.
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Do not use vaginal medications for the two days before the colposcopy.
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Do not use tampons the day or two before the colposcopy.
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Take pain relievers before the colposcopy appointment.
Few tips to reduce anxiety during the procedure:
Many women experience anxiety before colposcopy procedures. Anxiety can make them feel uncomfortable. Women who are very anxious about the procedure may experience more pain during the procedure than others who are not anxious.
To reduce anxiety,
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Ask the doctor for pamphlets, brochures, or colposcopy so they can understand what they can expect.
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Clarify any doubts about the procedure.
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Find activities to help relax, such as meditation, exercise, and being with family and friends.
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Ask the doctor if it is fine listening to music quietly during the exam because women may experience less pain and anxiety while listening to music during colposcopy.
What Is the Procedure of Colposcopy Biopsy?
A colposcopy is a microscope-like device with a strong light that is used to visualize the cervix. Colposcope does not enter the vagina but remains outside the body. The colposcope has a camera attached, so the cervix images can be on a small screen. Using some of the abnormalities of the cervix are highlighted.
Colposcopy is a safe procedure with minimal pain and no complications other than vaginal spotting. The examiner will look at the squamocolumnar junction, which is the area that gives rise to most cases of cervical cancer. The squamocolumnar junction is the border between the two different types of cells (squamous cells lining the cervix's outer surface and columnar cells lining the endocervical canal). During colposcopy, the entire squamocolumnar junction is mostly seen in young women. But in older women, due to menopause, the squamocolumnar junction may migrate inside the endocervical canal. In such cases of older women, colposcopy is not adequate. So, another procedure may need to be performed to check the entire squamocolumnar junction.
If any abnormal cells are identified, a small piece of tissue may be removed for closer examination. It may feel a small pinch or scratch in terms of sensation while removing the sample for examination. A biopsy aims to confirm whether the screening test correctly identifies a problem. This procedure usually takes about five minutes, but it can take about 10 to 15 minutes if any treatment is carried out.
What Tests Are Performed During Colposcopy Procedure?
Three special tests are performed during colposcopy.
They are,
Acetic Acid Wash for Colposcopy - During the examination, the cervix is cleaned with acetic acid, which is three to five percent diluted. The acetic acid will wash out the mucus, allowing clear visibility of abnormal areas with the colposcope, and stain the white areas called acetone white lesions. The normal areas can also stain white, but these areas may have faint or vague borders. But abnormalities, such as precancers, cancers, and genital warts, produce acetone white areas with clear and distinct boundaries.
Sometimes dilute iodine solution is used for staining (known as Schiller's solution or Lugol's solution) to further examine for abnormalities. Usually, normal cells take up the iodine stain and turn brown, whereas severe precancerous and cancerous areas will not.
Use of Color Filters - Using color filters helps doctors examine tiny blood vessels in the area of the squamocolumnar junction. While using blue or green-filtered light, the abnormal capillaries become more obvious. In normal conditions, the capillaries are slender and evenly spaced. But, abnormal capillaries can appear as red spots or a pattern resembling hexagonal floor tiles. The capillaries will be thicker and more widely spaced if the severe cervical disease. When cancer develops eventually, capillaries take on odd shapes and resemble punctuation marks.
Biopsy of the Cervix - The final step of colposcopy is tissue sampling targeting the abnormal areas. The biopsy of abnormal areas is critical because treatment depends on the severity of the abnormal samples. After taking the sample, a chemical is applied to that area to prevent bleeding. Endocervical curettage is also often performed along with a biopsy.
What Are the Complications of Colposcopy?
Colposcopy is usually a safe procedure. In rare cases, complication during biopsies can occur, which includes:
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Pelvic pain.
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Infections.
Conclusion
Colposcopy is a simple procedure used to examine the cervix or vagina. During the procedure, a small abnormal sample is collected from the cervix and sent to a laboratory for further examination. It creates little discomfort, but few complications like bleeding and infection can occur in rare cases.
