Colposcopy
A colposcopy is a gynecological diagnostic test that uses a microscope to examine the vagina and cervix externally. The procedure involves applying a special solution to the cervix, which highlights abnormal tissues and enhances their visualization.
General Description
Colposcopy is a diagnostic procedure that involves closely examining the vagina and cervix with an optical instrument.
The device used is called a colposcope. It is a stereoscopic microscope with lenses of varying magnifications and an integrated white light source. Additionally, it can be connected to a video camera and a monitor to record and view images later.
When is it indicated?
Colposcopy is generally indicated when abnormal or suspicious results are obtained from a cervical cytology test (Pap smear) to identify lesions or abnormalities in the cervix, primarily the following:
- Precancerous or cancerous cells.
- Genital warts (a possible sign of HPV infection).
- Non-cancerous polyps.
- Inflammation of the vagina (colpitis) or cervix (cervicitis).
Additionally, colposcopy is commonly used before a biopsy to identify the abnormal tissue that needs to be sampled.
How is it performed?
Before beginning the examination, a speculum is inserted into the vagina to separate the vaginal walls and allow visualization of the cervix. If necessary, the mucosa is cleaned with saline solution. An acetic acid or iodine solution is then applied to the cervix to highlight abnormal tissues, making them easier to identify (they appear whitish). The colposcope is positioned at the vaginal entrance, without being inserted, allowing the specialist to observe the entire area carefully. If deemed necessary, images may be recorded on video.
When abnormal tissue is detected, a sample is taken using a spoon-shaped instrument called a curette (cervical curettage biopsy).
Risks
A routine colposcopy presents no risks unless the patient is allergic to iodine or acetic acid. If a curettage biopsy is performed, potential complications include:
- Excessive bleeding.
- Infection.
- Pelvic pain.
What to expect during a colposcopy
Before starting, the patient removes clothing from the lower body and puts on the gown provided by the medical center. The exam takes place with the patient lying on her back on the examination table, feet resting in stirrups.
It is normal to feel discomfort or pressure when the speculum is inserted, as well as a burning or stinging sensation when the acetic acid or iodine solution is applied. If a biopsy is performed, a pinching sensation or cramping similar to menstrual pain may be felt. In this case, slow, deep breathing can help relax and ease the pain. After the sample is taken, a topical medication is applied to stop the bleeding.
The procedure, including the biopsy, takes approximately ten minutes. If only an examination is performed, the patient can leave and resume normal activities with no special precautions or side effects. If a biopsy is performed, mild vaginal pain, light bleeding, or dark discharge may occur for a couple of days. Additionally, sexual intercourse and tampon use should be avoided for at least one week afterward.
Specialties that request colposcopy
Colposcopy is requested in gynecology and obstetrics consultations.
How to prepare
For 48 hours before the colposcopy, patients should avoid sexual intercourse with penetration, tampon use, or vaginal medications. It is often recommended to take a pain reliever before the test to minimize potential discomfort. Additionally, the colposcopy should be scheduled before or after menstruation, never during. Patients must also inform their doctor if they are pregnant, as pregnancy increases the risk of bleeding if a biopsy is performed.
