A GENERAL LOOK AT COLPOSCOPY — Cervix cancer scans (with Pap test or HPV test) are an important device for staying healthy and protecting yourself from cervix cancer. Further examinations might be necessary in cases where the results of your scan are abnormal, in order to understand the seriousness of this abnormality.
Colposcopy is the test that is suggested in these situations. It gives the doctor an opportunity to view the cervix magnified. Biopsy might be applied during a colposcopy. Colposcopy (monitoring of the cervix) and biopsy (taking a small sample tissue to examine in the laboratory) can be done at the same time or the gynecologist might decide it’s not necessary.
Not all women with abnormal cervix cancer need treatment. Colposcopy might be useful to determine the necessity of treatment and the time in which it must be started if it is necessary.
WHY IS COLPOSCOPY NECESSARY? — Colposcopy is used following an abnormal cervix cancer scan and is used for monitoring abnormal areas detected on cervix, vagina and vulva. The results of a Pap smear test might be due to cancer that developed cause of the cervix being infected by HPV or an abnormality due to a pre-cancerous lesion.
Colposcopy magnifies the cervix. The doctor applies acetic acid or vinegar to cervix and vagina, in order to colour the cells to see where these cells are located and determine the sizes of the abnormal areas. The location, size and type of these abnormal cells, help determine on which area the biopsy will be done. This detection helps determine; the degree of abnormality, if treatment is necessary and the type of treatment if deemed necessary. In cases where pre-cancerous areas are diagnosed early, the advanced cancer development can generally be stopped.
PREPERATION FOR COLPOSCOPY — Do not put anything in your vagina before your colposcopy appointment.
Coploscopy can be carried out at any time during your menstrual cycle. But if you have heavy bleeding on the day of your appointment, you should call your doctor and determine another date.
If you are taking medicines for hemotopexia (aspirin, varfarin, heparin, clopidogrel etc.), let your doctor know. These medicines might accelerate bleeding during biopsy.
If you are pregnant or suspect that you might be, let your doctor know. Colposcopy is safe during pregnancy, but generally doctors will not be having a biopsy from the cervix during pregnancy.
COLPOSCOPY OPERATION — Kolposkopi özel eğitim almış hekim veya asistan hekim tarafından yapılabilir. Kolpoksopi yaklaşık 5-10 dakika sürer, çok az ağrıya sebep olur ve polikliniklerde yapılabilir.
Colposcopy is similar to a routine pelvic examination and is done on examination table. The doctor uses a device called speculum. Speculum allows the vagina to be opened in order to view the cervix. [Image 1 & Figure 1] The doctor might examine your cervix using colposcopy, after repeating a Pap smear test. Colposcop is a microscope and will not be touching you.
Gynecologist will apply a solution to the cervix called acetic acid. This solution helps determine abnormal areas and gives a better view for the colposcop. The solution might cause a mild cold & burning sensation, but it causes no pain.
A small tissue might be taken from the abnormal areas around the cervix or vagina during the colposcopy. The fact that a biopsy is done, doesn’t mean that you have pre-cancerous cells. The application of anaesthesia is nor necessary before a biopsy. Because biopsy procedure only causes a very small discomfort and mild contractions. The tissue sample is then sent to the laboratory and is examined by pathologist under a microscope.
For some women, an inner cervix biopsy is needed. This procedure is called Endocervical Curettage (ECC). Endocervical Curettage is not applied to pregnant women, due to the risk of impairing the pregnancy. Endocervical Curettage might cause a pain similar to cramps, but usually ends after a very brief period for most women.
If biopsy is taken, a yellow-brownish solution might be applied. This liquid is used as a bandage.
AFTER COLPOSCOPY — If a biopsy is taken from your cervix, there might be mild bleeding on your vagina. If liquid bandage is applied, a brown-black liquid that looks like coffee residue might leak out of the vagina. The leak of this liquid should slow down after a few days.
Most women can go back to work or school straight after their colposcopy. Some women might suffer mild pain and cramps. But this will generally only last about an hour or two.
Do not put anything in the vagina (cream, shower, tampons) and do not have sexual intercourse for about 48 hours after the biopsy.
If biopsy is taken, ask your doctor when the results will be out. The results are usually announced after 7-14 days. In most cases, further examinations and treatment is determined by the test results.
Do not assume that biopsy results are normal, unless your doctor tells you. Call and see your results. Most women need a follow up test (Pap smear or colposcopy) during the 6 months period after this procedure.
Situations where you might need to you’re your doctor after your colposcopy:
- Heavy vaginal bleeding (When a large size pantyliner gets totally wet within an hour and this situation lasts for two hours)
- Vaginal bleeding that exceeds 7 days.
- A disturbing smell from the vaginal leak (Do not forget that brown/blackish vaginal leaking is normal around the first few days)
- Pelvic pain or cramp that doesn’t pass after Ibuprofen (Advil, Motrin) use.
5. Fever over 38ºC
Source: This article was written using resources on on UpToDate website, in addition to ‘Modern Colposcopy Textbook and Atlas Third Edition’ by American Society for Colposcopy and Cervical Pathology (Author), E. J. Mayeaux Jr. MD DABFP FAAFP (Editor), J. Thomas Cox MD (Editor), which is translated into Turkish in editorial guidance of Prof. Dr. Ali Ayhan.
18 Ekim 2013 tarihinde Prof. Dr. Süleyman Engin Akhan tarafından yayınlanmış ve 13 Nisan 2018 tarihinde de son güncelleme yapılmıştır.