Colposcopy exam: what it is for, preparation and result

What is Colposcopy

Colposcopy is an examination performed by the gynecologist (or at his behest) to assess the vulva, vagina and cervix in detail. In it, the colposcope is used, a kind of binocular that illuminates and expands the vision of the region. However, the use of some solutions during the procedure may also be necessary, in order to improve observation.

Attention!
This test can only be performed on women who have been or are sexually active. For virgin women, a test called vulvoscopy is the most suitable, as it will be performed with a type of microscope that allows the region to be enlarged up to 40 times, making the virginity remain.

What is the Colposcopy exam for

This examination is usually requested after the specialist deems it necessary to perform a more thorough evaluation of the genital tract. This is due to two factors, mainly:

  1. When the Pap smear shows alterations suggestive of premalignant lesions.
  2. When, during the gynecological examination, the doctor identifies suspicious lesions in the mucosa of the vagina or cervix.

With colposcopy, it is possible to be sure whether or not there is a lesion in the region, where it is located, how extensive it is and what nature is benign (or inflammatory), pre-malignant (with the possibility of progressing to cancer) ) or malignant.

In addition, the exam can be used to detect and evaluate other types of problems, such as:

  • Genital warts on the cervix (most often caused by the HPV virus).
  • Cervicitis (inflammation of the cervix).
  • Benign polyps (irregular tissue growth).
  • Pelvic pain.
  • Bleeding (such as after sex).

Colposcopy exam preparation

To perform the colposcopy, no specific type of prior preparation is necessary, as the examination is carried out in the doctor’s office and lasts 15 to 20 minutes. However, you must make sure that you are not in your menstrual period, as the blood flow interferes with the image that the exam aims to have.

In addition to menstruation, other items may also interfere with the test result. Therefore, make sure that you:

  • He did not use a vaginal shower.
  • He did not apply any type of medication in the region.
  • You have not used tampon in the past 24 hours.
  • You haven’t had sex in the past 24 hours.
  • There is no infection in the vulva, vagina or cervix.
  • He emptied his bladder.

Colposcopy is usually painless, but some women claim to experience minor discomfort during the procedure. To prevent this from happening, you can take an analgesic, such as ibuprofen , 30 to 60 minutes before the test.

There is also the issue of anxiety which, in most cases where it happens, also causes general discomfort including difficulty sleeping and lack of concentration. Women who suffer from anxiety tend to experience more pain during colposcopy and, therefore, are advised to follow these tips:

  • Ask the doctor about leaflets that explain what the test is and what to expect from it.
  • Write down any questions and concerns you have about the procedure and ask the doctor everything.
  • Find activities that relax your body and mind, such as physical exercise and meditation.
  • Check if there is a possibility to take a portable device to listen to music while the exam is done.

Attention!

NEVER self-medicate or stop using a medication without first consulting a doctor. Only he will be able to tell which medication, dosage and duration of treatment is the most suitable for his specific case. The information contained on this site is only intended to inform, not in any way intended to replace the guidance of a specialist or serve as a recommendation for any type of treatment. Always follow the instructions on the package insert and, if symptoms persist, seek medical or pharmaceutical advice.

In case of pregnancy

Colposcopy does not present any risk for both the pregnant woman and the baby, but notifying the doctor that you are pregnant is important before taking the test.

How the Colposcopy exam is done

This exam is not very different from the usual gynecological exam. Therefore, the patient should remove the clothes from the lower part of the body and sit on the stretcher in the office, with legs apart. Once this is done, the gynecologist (or a trained nurse) will introduce a vaginal speculum (metal or plastic device used to keep the vagina open throughout the procedure) and move the colposcope close to her about 30 cm away.

The colposcope is a microscope that resembles a pair of binoculars. With this device, a very large range of image magnification is possible, in addition to also having a color filter that makes it possible to detect small abnormal blood vessels in the cervix. It is used to analyze the vaginal walls and cervix through the woman’s vaginal opening.

Through the magnifying glass of the device, the doctor is able to analyze in detail the entire region of the genital apparatus, even discovering lesions that are not detected by the naked eye. To obtain the desired image more easily, a solution of acetic acid can be applied in order to eliminate mucus and allow abnormal areas to stand out on the display normally in white. Often, in addition to this solution, a solution diluted with iodine (Lugol’s solution or Schiller’s solution) is also applied to further examine these abnormalities. Both solutions can cause burning when applied.

Colposcopy with biopsy

In cases of lesions detected during the exam, the doctor may perform a biopsy of the injured tissue, which is extremely important, since she will be responsible for determining the type of treatment in case of abnormalities in the samples. For biopsy, these samples are analyzed under a microscope and can mean both cancer and tissue susceptible to becoming cancerous. If there is bleeding in the collection procedure, silver nitrate can be used in the region in order to stop the blood.

Attention!
Women using anticoagulants should discontinue use for a few days before the test (if the biopsy needs to be done), as this will reduce the risk of bleeding.

Post-examination recommendations

After colposcopy, the vagina may be slightly sore for about two days, due to the insertion of the speculum and also the application of the solutions. In addition, if there was a biopsy during the procedure, light bleeding may also occur up to a week after the exam.

For a week, you will not be able to use / do:

  • Vaginal shower.
  • Sex.
  • Tampons.

Following these tips and the others made by your doctor, recovery is quick and without major complications. However, in the event of abnormalities, such as heavy vaginal bleeding, fever , stomach pain and unpleasant vagina odor, contact your doctor immediately.

Colposcopy exam results

There are two possible outcome options for colposcopy: normal and abnormal. After the exam, the person responsible for the entire procedure will let you know everything that was found in the region of your genital tract. If the biopsy has been done, the tissue analysis will most likely take four to eight weeks to complete.

Below are the differences between the results and what they mean:

Normal result

About four tests, out of ten, have the normal result. This means that abnormal cells were not found in your body during colposcopy and / or biopsy.

Abnormal result

According to statistics, most of the colposcopies performed have an abnormal result, that is, foreign cells were found in your cervix known as cervical intraepithelial neoplasia (CIN) or, also, cervical glandular intraepithelial neoplasia (NIGC). These cells are not cancerous, however, if left untreated, they can be.

There are four distinct types of biopsy results for these cells:

  • CIN 1: the cells are unlikely to become cancerous and can disappear without treatment.
  • CIN 2: there is a small chance that the cells will become cancerous and treatment to remove them is recommended.
  • CIN 3: there is a high chance of the cells becoming cancer later and treatment for removal is recommended.
  • NIGC: similar to NIC 3, NIGC cells will most likely become cancerous and treatment will be required for removal.

Depending on the type of your result, you should have immediate treatment, due to the abnormal cells, or redo the colposcopy exam, according to the following instructions:

  • If you have CIN 1 cells, repeat colposcopy should be done every six or 12 months, in order to monitor them and find out whether treatment is necessary or not.
  • If you have NIC 2 or 3 cells, immediate treatment is recommended.

Treatment in case of abnormalities

Depending on the evolution of the abnormal cell, the treatment may be carried out at the same time as the colposcopy is performed. But, if the treatment needs to be more intense, your doctor will alert you as to the duration and how to proceed.

Below are some treatment options that can be used:

Excision of the transformation zone by large loop (LLETZ)

The most common type of treatment, LLETZ consists of the removal of abnormal cells through a fine twisted wire, which is heated with an electric current. This procedure can be done during the colposcopy without any problem and an overnight stay in the hospital is not necessary.

Cone biopsy

Done less frequently than LLETZ, cone biopsy is a minor operation, which consists of cutting a piece of conical tissue that contains the abnormal cells. This treatment can only be carried out when there is a large area of ​​tissue that needs to be removed and there is no possibility of carrying it out during the same time as the examination is done. General anesthesia is usually used and it may be necessary to stay overnight in the hospital overnight.

Other treatments

Abnormal cells of the cervix can also be treated by:

  • Cryotherapy: abnormal cells are frozen and then destroyed.
  • Laser: used to locate and destroy abnormal cells.
  • Cold coagulation: a heat source is applied to the cervix, causing abnormal cells to be burned.
  • Hysterectomy: a procedure that removes the uterus completely, it only recurs if the abnormal cells have been found more than once during a colposcopy.

Post-treatment recommendations

In most cases, treatment has more benefits than complications or side effects, but that does not mean that they do not exist. Symptoms such as mild pain and brown vaginal discharge may appear and take up to four weeks to disappear.

Because of this, after treatment, some precautions must be taken into account:

  • Wait 24 hours to drive, in case of using general anesthesia.
  • Do not use tampon for four weeks.
  • Avoid sexual intercourse for four weeks.
  • Do not exercise for at least four weeks or while bleeding.

Treatment complications

Some more serious complications may happen, but on a smaller scale. They are:

  • Infection: usually causes bleeding, a bad smell in the vagina and severe and persistent pain in the belly.
  • Premature birth in future pregnancies: it is more likely to happen if the treatment has been done repeatedly or if a large part of the tissue needed to be removed.

The health of the genital system is of fundamental importance for all women. Therefore, always be up to date with your check up, including the Pap test , as, if necessary, a colposcopy can be recommended as soon as possible in case of abnormalities.

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