Colposcopy

Overview :

A colposcopy is performed in a physician's office and is similar to a regular gynecologic exam. An instrument called a speculum is used to hold the vagina open, 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 normal pink color). Abnormal areas can also be identified by looking for a characteristic pattern made by abnormal blood vessels. In 2004, a study showed that a new optical detection system used with colposcopy greatly improved visual detection of precancerous changes in the cervix during the procedure.

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, and if 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 (cryotherapy), 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.