Colposcopy-Directed Biopsy

Written by Ann Pietrangelo | Published on August 7, 2012
Medically Reviewed by George Krucik, MD

What is a Colposcopy?

A colposcopy (kol-POS-kuh-pee) is a method of examining the cervix, vagina, and vulva with a surgical instrument called a colposcope. The procedure is usually performed if the results of your Pap smear (the screening test used to identify abnormal cervical cells) are unusual. A colposcope is a large, electric microscope with a bright light that enables your doctor to see your cervix clearly.

If your doctor spots any abnormal areas, he or she will take a tissue sample (biopsy). The procedure to retrieve a tissue sample from inside the cervix is called endocervical curettage (ECC). The samples are sent to a lab for examination by a pathologist.

You may feel nervous if your doctor orders a colposcopy, but understanding the test and knowing what to expect can ease your anxiety. The test is generally quick and painless.

Why Is a Colposcopy Performed?

Your doctor may suggest a colposcopy if your Pap smear results are abnormal, if you experience bleeding after intercourse, or if you have an abnormal growth on your reproductive organs. A colposcopy can be used to diagnose:

How Do I Prepare for a Colposcopy?

There is little to do in the way of preparation for this test. However, here are a few things you should keep in mind:

  • Ask your doctor to explain the test in detail.
  • Tell your doctor if you think you may be pregnant.
  • Schedule the test for a time when you are not menstruating heavily. Light bleeding at the beginning or end of your period is usually fine, but check with your physician.
  • Do not douche, use tampons, or have sexual intercourse for 24-48 hours prior to the exam.
  • Some doctors recommend a mild over-the-counter pain reliever before the test. Discuss this with your doctor prior to the test day.
  • For comfort, empty your bladder and bowels before the test.

How Is a Colposcopy Performed?

The Procedure

A colposcopy is usually performed in a doctor’s office and takes 10 to 20 minutes. It requires no anesthetic. Here’s what you can expect:

  • You’ll lie on your back on a table with your feet in stirrups, just like during a pelvic exam or Pap smear.
  • Your doctor will position the colposcope a few inches away from your vulva and place a speculum in your vagina. The speculum holds the walls of your vagina open so that your doctor can see your cervix.
  • Your cervix and vagina will be swabbed with cotton and a solution of vinegar to clear away mucus and to highlight abnormal cells.
  • The colposcope does not touch you. Your doctor may take photographs and biopsy any areas that appear suspicious.

Discomfort

Some women find the insertion of the speculum uncomfortable and some report a stinging sensation from the vinegar solution. If you feel anxious during the test, concentrate on taking slow, deep breaths to help relax your body.

Biopsy Accompanying a Colposcopy

If you are having a biopsy, how the procedure feels will depend on the location being tested.

Cervical Biopsy

You may feel some pressure or cramping, but a cervical biopsy is generally painless.

Vaginal Biopsy

Most of the vagina has very little sensation, so you won’t feel pain during a biopsy. The lower part of the vagina has more sensation and your doctor may use a local anesthetic before proceeding.

What Are the Risks of a Colposcopy?

The risks following a colposcopy and biopsy are minimal, but rare complications include:

  • bleeding that is very heavy or lasts longer than two weeks
  • fever or chills
  • signs of infection, such as heavy, yellow-colored, or bad-smelling discharge from your vagina
  • pelvic pain

If you experience any of these symptoms, call your doctor immediately.

A colposcopy and biopsy will not make it more difficult for you to become pregnant.

What Happens After a Colposcopy?

After a colposcopy, you may have dark vaginal discharge for up to three days and some bleeding for up to a week. Your vagina may be sore and you may experience mild cramping.

If no biopsy was taken, you may resume normal activity right away. If you had a biopsy, avoid the use of tampons, douches, vaginal creams, and vaginal intercourse for a week. You may shower or bathe right away. Any concerns should be discussed with your doctor.

Regardless of the results, it is important to continue regular gynecological exams and Pap smears as your doctor recommends.

What Do the Results of a Colposcopy Mean?

Ask your doctor when you can expect the test results and follow up if you don’t receive the information in a timely manner. The results will help determine if you need additional tests or treatment.

If the results show no abnormalities, your doctor may recommend additional testing to see why your Pap smear was abnormal, or may suggest a follow-up exam.

Abnormal Biopsy Results

Your doctor may be able to remove all the abnormal cells during the test so that no further treatment is necessary. A pathologist will examine the tissue samples from the biopsy, looking for abnormalities.

Abnormal biopsy results may help to diagnose cancer and other treatable conditions. Your doctor will make recommendations based on the results of colposcopy and biopsy. Schedule time with your doctor to have all your questions answered and don’t hesitate to seek a second opinion.

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