Colposcopy Health Article

Definition

Colposcopy is a procedure that allows a physician to take a closer look at a woman's cervix and vagina using a special instrument called a colposcope. It is used to check for precancerous or abnormal areas. The colposcope can magnify the area between 10 and 40 times; some devices also can take photographs.

Purpose

The colposcope helps to identify abnormal areas of the cervix or vagina so that small pieces of tissue (biopsies) can be taken for further analysis.

Colposcopy is used to identify or rule out the existence of any precancerous conditions in the cervical tissue.

If a PAP test shows abnormal cell growth, further testing, such as colposcopy, often is required. A PAP test is a screening test that involves scraping cells from the outside of the cervix. If abnormal cells are found, the physician will attempt to find the area that produced the abnormal cells and remove it for further study (biopsy). Only then can a diagnosis be made.

Colposcopy may also be performed if the cervix looks abnormal during a routine examination. It may also be suggested for women with genital warts and for diethylstilbestrol (DES) daughters (women whose mothers took DES when pregnant with them).

Precautions

Women who are pregnant, or who suspect that they are pregnant, must tell their doctor before the procedure begins. Pregnant women can, and should, have a colposcopy if they have an abnormal PAP test. However, special precautions must be taken during biopsy of the cervix.

Description

A colposcopy is performed in a physician's office and is similar to a regular gynecologic exam. An instrument called a speculum is used to hold the vagina open, and the gynecologist looks at the cervix and vagina through the colposcope instead simply by eye, as in a routine examination.

The colposcope is placed outside the patient's body and never touches the skin. The cervix and vagina are swabbed with dilute acetic acid (vinegar). The solution highlights abnormal areas by turning them white (instead of a normal pink color). Abnormal areas can also be identified by looking for a characteristic pattern made by abnormal blood vessels.

If any abnormal areas are seen, the doctor will take a biopsy of the tissue, a common procedure that takes about 15 minutes. Several samples might be taken, depending on the size of the abnormal area. A biopsy may cause temporary discomfort and cramping, which usually go away within a few minutes. If the abnormal area appears to extend inside the cervical canal, a scraping of the canal may be done. The biopsy results are usually available within a week.

If the tissue sample indicates abnormal growth (dysplasia) or precancer, and if the entire abnormal area can be seen, the doctor can destroy the tissue using one of several procedures, including ones that use high heat (diathermy), extreme cold (cryosurgery), or lasers. Another procedure, called a loop electrosurgical excision (LEEP), uses low-voltage high-frequency radio waves to excise tissue. If any of the abnormal tissue is within the cervical canal, a cone biopsy (removal of a conical section of the cervix for inspection) will be needed.