What is a colposcopy?
A colposcopy (kol-POSS-ko-pee) is an exam of the cervix, the vagina, or both. This exam uses an instrument called a colposcope (KOLpo-skope). The vagina is the passageway to the uterus (womb). The uterus is where a baby grows during pregnancy. The cervix is the lower part of the uterus (see diagram). A colposcope is a long, thin scope with a magnifier. It allows the doctor to see changes in cells that cannot be seen by the naked eye. The exam is not painful, but it may be a little uncomfortable. It usually takes between 5 and 10 minutes.
Why is a colposcopy performed?
A colposcopy is performed if a woman:
- Has an abnormal Pap test
- Has genital warts or an unusual look to the cervix, vagina, or vulva (external genitals)
- Was born to a woman who was treated with DES (diethylstilbestrol) during pregnancy
If you need a colposcopy
If you need to have a colposcopy, it does not mean that you have cancer. The most common reason for having a colposcopy is a Pap test that shows abnormal cells. This is known as dysplasia (dis-PLAY-zsha). The abnormal cells may be pre-cancerous. This means they could turn into cancer if left untreated. A biopsy of the abnormal tissue will tell whether or not you need treatment. If pre-cancerous cells are found and treated early, cancer can be prevented.
Some terms used to describe abnormal cells on a Pap test include CIN (cervical intraepithelial neoplasia) and SIL (squamous intraepithelial lesion). Your doctor will explain these terms if they apply to you.
Preparing for a colposcopy
To prepare for a colposcopy:
- Do not douche or have sex for 48 hours before the exam.
- Schedule your appointment for a day when you do not have your period.
What happens during a colposcopy?
A colposcopy is done in your doctor’s office. During the exam, you will be asked to lie on your back on an exam table. Your legs will be put into stirrups, just like during your annual gynecologic exam. You will be asked to relax as much as possible. An instrument called a speculum (SPECK-you-lum) will be inserted into your vagina. The speculum gently separates the walls of the vagina.
At this point, a Pap test may be done. This is a gentle swab to take a few cells from your cervix.
Next, your cervix will be cleansed with a solution. Your doctor then will look at your cervix using the colposcope. You may need to have a biopsy. This involves removing very small pieces of tissue from the cervix. The samples are sent to a lab to be looked at under a microscope. The biopsy may cause mild cramping and spotting (very slight bleeding). A medicine called Monsel solution may be applied to the biopsy site to stop the bleeding.
The inside of the cervical canal may be scraped to check for abnormal cells. This scraping also may cause mild cramping and spotting.
After the colposcopy
- The discomfort that you have from the biopsy will not last long and will not limit your activities. You may have spotting for 1 to 2 days.
- If Monsel’s Solution was used on the biopsy site, you may have a brownish vaginal discharge that looks like coffee grounds for1 to 2 days.
- To prevent infection, do not use tampons for 1 week.
- You may have sex any time after the bleeding stops.
Follow these suggestions to help the biopsy sites heal quickly and to help prevent infection and further bleeding.
Depending on the results of your biopsy, you may need to have further treatment. There are many ways to treat dysplasia. Your doctor will talk to you about which of the following treatments is best for you:
Cryotherapy (kry-oh-THAIR-uh-pee) removes abnormal cells from your cervix through freezing. This procedure takes 10 minutes and is done in the doctor’s office. The doctor may give you a local anesthetic. You may feel some mild cramping during the procedure and for a little while afterward.
LEEP (loop electrosurgical excision procedure)
LEEP (loop electrosurgical excision procedure) removes abnormal cells from your cervix using an electrical wire. It also is done in the doctor’s office. A local anesthetic usually is given. You may have mild cramping during the procedure and for a little while afterward.
Removes abnormal cells on the cervix using a laser. This is done if the abnormal area is too large for cryotherapy or LEEP. Laser treatment is done in the operating room. Most patients don’t have to stay overnight in the hospital. Anesthesia usually is not needed.
Colon Biopsy involves removing a larger, cone-shaped piece of the cervix. This is done in the operating room with general anesthesia, which means you will be asleep. This method may be used for treatment if the entire abnormal area cannot be seen with the colposcope. If you have any of these procedures, you will need to have frequent Pap tests for several years. Your doctor will tell you how often.
Keep your appointments
If you are being treated for dysplasia, it’s very important to keep all appointments. Please tell your doctor’s office of any telephone or address changes. If you have any problems or questions, call your doctor.