Colposcopy is a way of looking at the cervix through a special magnifying device called a colposcope. It shines a light onto the vagina and cervix. A colposcope can enlarge the normal view by 2–60 times. This allows the doctor to find problems that cannot be seen by the eye alone.
The Cervix
The cervix is the lower, narrow end of the uterus. Cells on the cervix grow all the time, just like skin. The cells at the bottom layer slowly move to the surface. Then they shed. When the process changes in some way, cells become abnormal. The changes may go away on their own. If they don't, they may worsen and lead to cervical cancer. In most cases, these changes are found with a Pap test, which can find changes in cells of the cervix that could lead to a problem. As part of their regular health care, a Pap test will be recommended according to national guidelines or as symptoms warrant. An annual wellness exam is recommended.
Reasons for Colposcopy
A colposcopy is done when a Pap test shows changes that could lead to cancer. It provides more information about abnormal cells.
Colposcopy also may be used to further assess certain problems:
- Genital warts on the cervix
- Cervicitis (an inflamed cervix)
- Benign (not cancer) growths, such as polyps
- Pain
- Bleeding
Sometimes colposcopy may need to be done more than once. It also can be used to check the result of a treatment.
The Procedure
Colposcopy is done like a Pap test in a doctor's office. You may be referred to another doctor or to a special clinic to have it done. Colposcopy may involve taking pictures of your vagina and cervix. Your doctor will talk to you about it before the procedure. The procedure is best done when a woman is not having her period. For at least 24 hours before the test, it is a good idea not to:
- Douche
- Use tampons
- Use vaginal medications
- Have sex
As with a pelvic exam, you will lie on your back with your feet raised and placed on foot rests for support. A speculum will be used to spread apart the vaginal walls so that the inside of the vagina and the cervix can be seen. The colposcope is placed just outside the entrance of your vagina. A mild solution will be applied to your cervix and vagina with a cotton swab or cotton ball. This liquid makes abnormal areas on the cervix easier to see.
Biopsy
During a colposcopy, the doctor may see abnormal areas. A biopsy of these areas may be done. During a biopsy, a small piece of abnormal tissue is removed from the cervix. The sample is removed with a special device. Cells may be taken from the canal of the cervix. Because the cells are not easy to see by the colposcope, a special device is used to scrape the cells. This scraping is called endocervical curettage (ECC).
Results
If a biopsy was taken, it will be studied in a lab. When biopsy results come back from the lab, your doctor will discuss them with you. Depending on the results, you may need to be checked more often, or you may need further testing or treatments.
Recovery
If you have a colposcopy without a biopsy, you should feel fine right away. You can do things you normally do. You may have a little spotting for a couple days.
If you have a colposcopy with a biopsy, your vagina may feel sore for 1 or 2 days. You may have some vaginal bleeding. You also may have a dark discharge for a few days. This may occur from a medication used to help stop bleeding at the biopsy site. You may need to wear a sanitary pad until the discharge stops. Your doctor may suggest you limit your activity for a brief time. While the cervix heals, do not put anything in your vagina for at least 1 week:
- Do not have sex.
- Do not use tampons.
- Do not douche.
Call your doctor right away if you have any of these problems:
- Heavy vaginal bleeding (using more than one sanitary pad per hour)
- Severe lower abdominal pain
- Fever
- Chills
- Bad-smelling vaginal discharge