Colposcopy

What is colposcopy?

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

• Cervix. The lower, narrow part of the uterus located between the bladder and the rectum, forming a canal that opens into the vagina, which leads to the outside of the body.
• Vagina. This is the passageway through which fluid passes out of the body during menstrual periods. The vagina connects the cervix and the vulva (the outer genitalia).

Why might I need a colposcopy?

Your provider may do a colposcopy if he or she finds problems or abnormal cells during a pelvic exam or Pap test. Through the colposcope, the healthcare provider can see certain changes in cervical and vaginal tissues. These include abnormal blood vessels, tissue structure, color, and patterns. Your provider may call cells that look abnormal, but are not yet cancerous “precancerous.” These abnormal cells may be the first signs of cancer that develops years later.

If your provider sees abnormal tissue during a colposcopy, he or she may take a small sample of tissue for further study. The healthcare provider may also take tissue samples from inside the cervix.

Your provider may use colposcopy to diagnose and assist in the treatment of:

• Bleeding
• Polyps (noncancerous growths)
• Genital warts, which may suggest infection with human papilloma virus (HPV), a risk factor for developing cervical cancer
• Diethylstilbestrol (DES) exposure in women whose mothers took DES during pregnancy, as DES exposure raises the risk for cancer of the reproductive system

Your healthcare provider may have other reasons to recommend colposcopy.

What are the risks for a colposcopy?

Possible complications of biopsy may include:

• Infection
• Bleeding

If you are allergic to or sensitive to medicines, iodine, or latex, tell your healthcare provider.

If you are pregnant or think you could be, tell your healthcare provider.

If possible, schedule your colposcopy about a week after your period.

There may be other risks based on your condition. Be sure to discuss any concerns with your healthcare provider before the procedure.

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

• Having your period
• Acute pelvic inflammatory disease
• Acute inflammation of the cervix

How do I get ready for a colposcopy?

• Your healthcare provider will explain the procedure and you can ask questions.
• You may be asked to sign a consent form that gives your permission to do the procedure. Read the form carefully and ask questions if something is not clear.
• Generally, you don’t need any preparation, such as fasting or sedation. If you have a biopsy under regional or general anesthesia, you may need to fast for a certain number of hours before the procedure, generally after midnight.
• If you are pregnant or think you could be, tell your healthcare provider.
• Tell your healthcare provider if you are sensitive to or are allergic to any medicines, latex, tape, iodine, and anesthesia.
• Tell your healthcare provider of all medicines (prescribed and over-the-counter) and herbal supplements that you are taking.
• Tell your healthcare provider if you have a history of bleeding disorders or if you are taking any blood-thinning medicine (anticoagulants), aspirin, or other medicines that affect blood clotting. You may be told to stop these medicines before the procedure.
• Do not use tampons, vaginal creams or medicines, douche, or have sex for 24 hours before the test.
• Your healthcare provider may recommend that you take a pain reliever 30 minutes before the procedure, or he or she will give you a sedative before the anesthesia is started. If sedation is given, you will need someone to drive you home afterwards.
• You may want to bring a sanitary pad to wear home after the procedure.
• Based on your condition, your healthcare provider may request other preparation.

What happens during a colposcopy?

You may have a colposcopy in your healthcare provider’s office or during a hospital stay. Procedures may vary based on your condition and your healthcare provider’s practices.

Generally, a colposcopy follows this process:

1. You will need to undress completely or from the waist down and put on a hospital gown.
2. You will empty your bladder before the procedure.
3. You will lie on an exam table, with your feet and legs supported as for a pelvic exam.
4. Your healthcare provider will insert an instrument called a speculum into your vagina to spread the walls of the vagina apart to expose the cervix.
5. He or she will place the colposcope, which is like a microscope with a light on the end, at the opening of your vagina. The colposcope does not enter your vagina.
6. Your healthcare provider will look through the colposcope to look for any problems on the cervix or in the vagina.
7. Your provider may clean and soak your cervix with a vinegar solution, also called an acetic acid solution. This solution helps make the abnormal tissues turn white and become more visible. You may feel a mild burning sensation. An iodine solution may be used to coat the cervix, called the Schiller test.
8. Your healthcare provider may take a small tissue sample called a biopsy. When this is done, the area is numbed, but you may feel a slight pinch or cramp as the tissue is removed.
9. Your provider may take a sample of cells from the inside of the cervical canal. This may also cause some cramping.
10. Your provider may use a paste-like topical medicine or pressure dressing to treat bleeding from the biopsy site.
11. The tissue will be sent to a lab for testing.

What happens after a colposcopy?

After a colposcopy procedure, you may rest for a few minutes before going home.

If you have a colposcopy with a biopsy, the recovery process will vary. It will depend on the type of biopsy done and the type of anesthesia (if any) used.

If you have regional or general anesthesia, you will be taken to the recovery room for observation. Once your blood pressure, pulse, and breathing are stable and you are alert, you will be taken to your hospital room or discharged to your home. If you have this procedure on an outpatient basis, plan to have someone drive you home.

You may want to wear a sanitary pad for bleeding. If you have a biopsy, it is normal to have some mild cramping, spotting, and dark or black-colored discharge for several days. The dark discharge is from the medicine applied to your cervix to control bleeding.

If you had a biopsy, do not to douche, use tampons, or have sex for one week after the procedure, or for as long as your healthcare provider advises.

You may also have other limits on your activity, including no strenuous activity or heavy lifting.

You may go back to your normal diet unless your health care provider tells you otherwise.

Take a pain reliever for cramping or soreness as directed by your healthcare provider. Aspirin or certain other pain medicines may increase the chance of bleeding. Be sure to take only recommended medicines.

Your healthcare provider will tell you when to return for further treatment or care. Generally, women who have had a cervical biopsy will need Pap tests more often.

Tell your healthcare provider if you have any of the following:

• Bleeding
• Foul-smelling drainage from your vagina
• Fever and/or chills
• Severe pelvic (lower abdominal) pain

Your healthcare provider may give you other instructions after the procedure, depending on your situation.