Colposcopy is a procedure that allows a physician to take a closer look at awoman's cervix and vagina using a special instrument called a colposcope. Itis used to check for precancerous or abnormal areas. The colposcope can magnify the area between 10 and 40 times; some devices also can take photographs.

The colposcope helps to identify abnormal areas of the cervix or vagina so that small pieces of tissue (biopsies) can be taken for further analysis.

Colposcopy is used to identify or rule out the existence of any precancerousconditions in the cervical tissue. If a PAP test shows abnormal cell growth,further testing, such as colposcopy, often is required. A PAP test is a screening test that involves scraping cells from the outside of the cervix. If abnormal cells are found, the physician will attempt to find the area that produced the abnormal cells and remove it for further study (biopsy). Only then can a diagnosis be made.

Colposcopy is sometimes performed if the cervix looks abnormal during a routine examination. It may also be suggested for women with genital warts and fordiethylstilbestrol (DES) daughters (women whose mothers took DES when pregnant with them).

Women who are pregnant, or who suspect that they are pregnant, must tell their doctor before the procedure begins. Pregnant women can, and should, have acolposcopy if they have an abnormal PAP test. However, special precautions must be taken during biopsy of the cervix.

A colposcopy is performed in a physician's office and is similar to a regulargynecologic exam. An instrument called a speculum is used to hold the vaginaopen, and the gynecologist looks at the cervix and vagina through the colposcope instead simply by eye, as in a routine examination.

The colposcope is placed outside the patient's body and never touches the skin. The cervix and vagina are swabbed with dilute acetic acid (vinegar). The solution highlights abnormal areas by turning them white (instead of a normalpink color). Abnormal areas can also be identified by looking for a characteristic pattern made by abnormal blood vessels.

If any abnormal areas are seen, the doctor will take a biopsy of the tissue,a common procedure that takes about 15 minutes. Several samples might be taken, depending on the size of the abnormal area. A biopsy may cause temporary discomfort and cramping, which usually go away within a few minutes. If the abnormal area appears to extend inside the cervical canal, a scraping of the canal may be done. The biopsy results are usually available within a week.

If the tissue sample indicates abnormal growth (dysplasia) or precancer, andif the entire abnormal area can be seen, the doctor can destroy the tissue using one of several procedures, including ones that use high heat (diathermy),extreme cold (cryosurgery), or lasers. Another procedure, called a loop electrosurgical excision (LEEP), uses low-voltage high-frequency radio waves to excise tissue. If any of the abnormal tissue is within the cervical canal, a cone biopsy (removal of a conical section of the cervix for inspection) will be needed.

Occasionally, patients may have bleeding or infection after biopsy. Bleedingis usually controlled with a topical medication. Any unusual symptoms such asheavy vaginal bleeding, fever, or abdominal pain should immediately be brought to the attention of a physician.

If visual inspection shows that the surface of the cervix is smooth and pink,this is considered normal. If abnormal areas are found and biopsied and theresults show no indication of cancer, a precancerous condition, or other disease, this also is considered normal.

Abnormal conditions that can be detected using colposcopy and biopsy includeprecancerous tissue changes (cervical dysplasia), cancer, and cervical warts(human papilloma virus).

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