Colposcopy

What is colposcopy?

Healthcare provider utilises colposcopy to view the opening to the uterus, called the cervix, as well as the vagina. It utilizes an instrument with a magnifying lens and a light called a colposcope. It magnifies the image many times. The healthcare provider observes the tissues on the cervix and vaginal walls more clearly. In a few cases, the healthcare provider will take a small sample of tissue for the exam in the lab. This is called a cervical biopsy.

Cervix - the lower, narrow portion of the womb which is present between the bladder and the rectum part, forming a canal that opens into the vagina, which leads to the exterior of the body.

Vagina - the passageway through which fluid moves out of the body during menses/ Aunt Flo. The vagina joins the cervix and the outer genitalia.

Need of a colposcopy

Healthcare provider may do a colposcopy if he or she finds issues or abnormal cells during a pelvic examination or Pap test. Through the colposcope, the healthcare provider can observe certain modifications in cervical and vaginal tissues. These comprise abnormal blood vessels, tissue structure, colour, as well as patterns. Healthcare provider may address cells that appear unusual but are not yet cancerous “precancerous.” These unusual cells may be the first signs of cancer that develops years later.

If healthcare provider observes abnormal tissue during a colposcopy, he/she may take a small sample of tissue for further examination. The healthcare provider may also extract tissue samples from inside the cervix.

Healthcare provider may employ colposcopy to diagnose and assist in the treatment of:

• Bleeding
• Genital warts, which may indicate infection with human papilloma virus (HPV) - a risk factor for developing cervical cancer
• Exposure of Diethylstilbesterol (DES) in females whose mothers consumed DES during pregnancy, as DES exposure raises the likelihood for cancer of the reproductive system
• Polyps (noncancerous growths)

How to get ready for a colposcopy?

• Healthcare provider will explain the procedure.
• Woman may be asked to sign a consent form that gives acknowledgement to do the procedure.
• Usually, woman don’t require any preparation, like fasting or sedation. If woman has a biopsy under regional or general anaesthesia, she may need to fast for a certain number of hours prior to the procedure, generally post-midnight.
• Woman may be asked to stop taking blood thinning medications
• Woman should not utilise tampons, vaginal creams or medicines, douche, or have intercourse for 24 hours prior to the test.
• Healthcare provider may recommend that woman may take a pain reliever 30 minutes prior to the procedure, or he or she will give woman a sedative before the anaesthesia is commenced. If sedation is given, she will need someone to drive her home afterwards.
• She may want to bring a sanitary pad to wear home post the procedure.

What happens during a colposcopy?

Woman may have a colposcopy in healthcare provider’s office or during a hospital stay. Procedures may differ based on woman's health condition and healthcare provider’s practices.

Usually, a colposcopy follows this process:

• Woman will need to undress completely or from the waist down and put up a hospital gown.
• Woman will void bladder prior to the procedure.
• Woman will lie on an exam table, with feet and legs supported as for a pelvic exam.
• Healthcare provider will insert an instrument known as a speculum into vagina to spread the walls of the vagina portion apart to expose the cervix.
• He/she will place the colposcope, which is like a microscope with a light on the end, at the opening of woman's vagina. The colposcope does not enter vagina.
• Healthcare provider will peep through the colposcope to check for any issues on the cervix or in the vagina.
• Healthcare provider may cleanse and soak cervix with a vinegar solution, also known as an acetic acid solution. This solution aids in making the abnormal tissues turn white and become more visible. Woman may feel a mild burning sensation. An iodine solution may be utilised to coat the cervix, called the Schiller test.
• Healthcare provider may extract a small tissue sample called a biopsy. When this is performed, the area is numbed, but woman may feel a slight pinch or cramp as the tissue is removed.
• Healthcare provider may extract a sample of cells from the inside of the cervical canal. This may also cause some cramping.
• Healthcare provider may utilise a paste-like topical medication or pressure dressing to cure bleeding from the biopsy area.
• The tissue will be dispatched to a laboratory for testing.

What happens after a colposcopy?

• Post a colposcopy procedure, woman may rest for a few minutes prior to going home.
• If she had a colposcopy with a biopsy, the process of recovery will differ. It will depend on the type of biopsy done and the anaesthesia type (if any) utilised.
• If she had regional or general anaesthesia, she will be taken to the recovery room for observation. Once her blood pressure, pulse, and breathing are stable and she is alert, she will be taken to hospital room or discharged to home. If she is having this procedure on an outpatient basis, she should plan to have someone drive her home.
• She may require wearing a sanitary pad for bleeding. If she had a biopsy, it is usual to have some mild cramping, spotting, as well as dark or black-coloured discharge for few days. The dark discharge is from the medicine applied to cervix to control bleeding.
• If she had a biopsy, she should not douche, utilise tampons, or have sex for 7 days after the procedure, or for interval healthcare provider advises.
• She may also have other limits on her physical activity, including no strenuous activity or heavy lifting.
• Woman may go back to routine diet unless health care provider tells her otherwise.
• She should take a pain reliever for cramping or soreness as directed by healthcare provider. Aspirin or certain other pain medications may raise the probability of bleeding. She should ensure to take only recommended medications.
• Healthcare provider will tell her when to return for further treatment or care. Generally, woman who have had a cervical biopsy will require Pap tests more often.

Risks for a colposcopy

Possible complications of biopsy may comprise:

• Infection
• Bleeding

Certain factors or health conditions may interfere with a colposcopy. These factors comprise:

• Having menses
• Acute pelvic inflammatory disease
• Acute cervix inflammation

In a nutshell, colposcopy is a way of looking at the cervix, vagina, and vulva through a special magnifying device known as a colposcope. In case of any complications, post completion of procedure, woman should seek immediate medical attention.

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