"When women are depressed, they eat or go shopping. Men invade another country. It's a whole different way of thinking." ~ Elayne Boosler
Colposcopy
If the results of your screening test are abnormal, further testing is needed to confirm the result and determine the severity of the abnormality. Colposcopy is the test that is usually recommended in this case. It allows us to look at your cervix using magnification.
Not all women with an abnormal cervical screening test will need treatment. Colposcopy can help to determine if and when treatment of the abnormality is needed.
Why Do I Need Colposcopy?
The colposcope magnifies the appearance of the cervix. This allows the clinician to better see where the abnormal cells are located and the size of any abnormal areas. The size and location of abnormal cells helps to determine how severe the abnormality is and also helps to determine what treatment, if any, is needed. When monitored and treated early, pre-cancerous areas usually do not develop into cervical cancer.
PREPARING FOR COLPOSCOPY
Before your colposcopy appointment, you should not put anything in the vagina (eg, creams). Colposcopy can be done at any time during your menstrual cycle, but if you have heavy vaginal bleeding on the day of your appointment, call us to ask if you should reschedule.
If you take any medication to prevent blood clots (aspirin, warfarin, heparin, clopidogrel), please call the office in advance. These medications can increase bleeding if you have a biopsy during the colposcopy. If you know or think you could be pregnant, let us know prior to the procedure. Colposcopy is safe during pregnancy, but we not usually do biopsies of the cervix if you are pregnant.
Colposcopy appointment takes approximately 20 minutes, but most of the visit is spent discussing the possibilities and then painless looking through the coloposcope at your cervix up close.
Colposcopy positioning is the same as that for a routine pelvic examination, while you lie on an exam table, we will place a speculum lightly inside your vagina to look at your cervix. We will then will look at your cervix using the colposcope. The colposcope is like a microscope on a stand - it does not touch you. You'll feel a gentle application of a dilute acetic acid (vinegar) to your cervix.
This solution helps to highlight any abnormal areas, making them easier to see with the colposcope. When this solution is used, you may feel a cold, but it does not hurt. During colposcopy, any abnormalities that are visualized will be biopsied (with a small cervical tissue sampler.)
Having a biopsy does not mean that you have precancerous cells. Anesthesia (numbing medicine) is not usually used before the biopsy because the biopsy causes only mild discomfort or cramping. The tissue sample will be sent to a laboratory and examined with a microscope.
Some women also need to have a biopsy of the inner cervix during colposcopy; this is called endocervical curettage (ECC). Pregnant women should not have ECC because it may disturb the pregnancy. The ECC may cause crampy pain, although this resolves quickly in most women.
If you have a biopsy, we may apply a yellow-brown paste to your cervix. This acts as a liquid bandage.
After Colposcopy
If you have a biopsy of your cervix, you will likely have a small amount of vaginal spotting. If we used the liquid bandage solution to stop bleeding, you may have brown or black vaginal discharge that looks like coffee grounds. This is not your cervix sloughing off - just the paste being passed. This resolves within a few days.
Most women are able to return to work or school immediately after having a colposcopy. Some women have mild pain or cramping, but this usually goes away within one to two hours.
Please do not put anything in the vagina (creams, douches, tampons) and do not have sex for one week after having a biopsy.
If you have a biopsy, your test is sent to pathology, and we will have your results usually within 14 days. In most cases, further testing and treatment will depend on the results of the biopsy.
If you have low-grade dysplasia or persistent atypical squamous cells, we will repeat your Pap smear in 6 months. If the biopsy shows high-grade dysplasia, we will recommend removal of the transformation zone, a small portion of your cervix, that is diseased, so it will not progress. This can be done in an office procedure, or in the operating room if you prefer, via LEEP (Loop Electrosurgical Excision Procedure.)
For the next 2 years, we will repeat your Pap smears every 6 months until you have 2 consecutive normal results, then you will return to annual screening.
