Colposcopy is used to follow up an abnormal cervical cancer screening tests (eg, Pap smear, human papillomavirus (HPV) testing) or abnormal areas are seen on the cervix, vagina, or vulva. Your Pap smear may be abnormal if you have cervical pre-cancer or cancer, often caused by human papillomavirus (HPV) infection of the cervix.
A colposcopy (pronounced kol-POSS-kuh-pee) is a screening test your OB-GYN can use to examine your cervix, vulva, and vagina for signs of illness, such as cervical cancer, human papillomavirus or genital warts. A colposcopic procedure is performed using a special microscope, called a colposcope, that gives a magnified view of tissue lining the cervix and vagina.
Sometimes a colposcopic procedure is performed when a Pap test (pap smear)during a pelvic exam has shown abnormal cellular growth. If your OB-GYN finds abnormal cells during a colposcopy, they can perform a biopsy to obtain a sample of tissue for further testing for additional test results.
Colposcopy Results, What can they Show?
A colposcopy can help your doctor diagnose the following:
- Cervical cancer
- Vulvar cancer
- Vaginal cancer
- Precancerous changes of the cervix, vulva, or vagina
- Cervicitis (inflammation of the cervix)
- Genital warts
How is a Colposcopy Performed?
A colposcopy is a nonsurgical procedure that can be performed right in your doctor’s office. It typically takes about 15 minutes.
Your doctor will have you undress from the waist down, lay on the exam table and rest your feet in stirrups, similarly to a normal pelvic exam. A speculum – a long, narrow, duckbill-shaped instrument – will be inserted into your vagina, allowing your doctor to view your cervix.
Since most patients can find this procedure uncomfortable, Dr. Aliabadi always uses numbing medication on the cervix and Nitrous Oxide (aka “laughing gas”) which virtually eliminates anxiety and helps with any remaining discomfort.
The colposcope (KOLE-po-scope), a magnifying instrument, will be positioned just outside of your vulva. The doctor will shine a light through the colposcope, which will illuminate the cervix and allow your doctor to see the abnormal areas. Your doctor will apply a solution to the area to draw attention to anything suspicious. This may burn or tingle slightly.
Colposcopy magnifies the appearance of the cervix. Vinegar or acetic acid or vinegar is placed on the cervix and vagina to stain the cells and to allow the doctor to see where the abnormal tissues are located and determine the size of any abnormal cells. The size, type, and location of abnormal cells assist to identify which area or areas may need to be biopsied. When monitored and treated early, pre-cancerous areas usually do not develop into cervical cancer.
Your OB-GYN may wish to take a tissue sample for further testing, possibly for a cervical cancer screening test. A sharp instrument is used to remove a small sample of tissue from the suspicious area. A cervical biopsy isn’t necessarily painful, but numbing agents are available. It is uncomfortable and can lead to some cramping.
You might have some spotting, vaginal bleeding, or dark discharge from your vagina for a few days after a biopsy.
How to Prepare for Your Colposcopy
If colposcopy is needed, your OB-GYN will recommend that you:
- Schedule your procedure during a time when you are not having your period
- Do not use tampons and vaginal medications for at least 48 hours before the procedure
- Abstain from vaginal intercourse for at least 48 hours prior to your appointment
- Take an over-the-counter pain reliever about 30 minutes prior to your procedure. You can use either nonsteroidal anti-inflammatories (like ibuprofen, Advil, or Motrin) or acetaminophen (Tylenol).
Having a colposcopy can provoke some anxiety and as we mentioned earlier, most patients find the procedure uncomfortable. So Dr. Aliabadi always uses numbing medication on the cervix and Nitrous Oxide (aka “laughing gas”) which virtually eliminates anxiety and helps with any remaining discomfort.
You may find it comforting to learn more about the procedure prior to your appointment. Make note of any questions or concerns you have and bring them to your doctor ahead of time.
You are also welcome to bring a portable music device with headphones to listen to during your procedure. Many women find that focusing on their favorite music helps them set aside their anxiety and distracts from the discomfort.
What to Expect After a Colposcopy
After a colposcopy, it’s normal to experience some spotting or brownish discharge for the next few days. This is normal and can be managed with sanitary pads. Do not use tampons during this time. If your doctor took a biopsy during your colposcopy, you will need to avoid tampons, sexual activity, and any activity that involves inserting objects or fluids into your vagina. This is to reduce the risk of infection.
Risks of Colposcopy
Colposcopies are generally very safe procedures with few risks. However, all medical procedures do carry some risk. Your healthcare doctor will explain the risks and help you understand the steps that are taken to reduce risk.
Following your colposcopy, if you experience heavy bleeding, severe pelvic pain, or if you develop a fever, you may have an infection. Call your doctor right away if you think something may be wrong.