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If Your Doctor Wants to do a Colposcopy

“Hi! We need to you come in for some tests.”

No women wants to get that call from your OBGYN, However it is not always as scary as you might think. It you do get a call from your doctor after your pap smear and they suggest a Colposcopy don’t be afraid.

What is a Colposcopy?

A colposcopy is a test where you OBGYN uses a special magnifying glass and light, a colposcope, to look directly at the vulva, vagina and cervix. This allows the doctor to see cellular changes which may be causing the pap smear test to come back abnormal.

Many abnormal Pap tests are caused by viral infections, such as HPV infection, or other types of infection like bacteria, fungi (yeast), or protozoa (Trichomonas). Abnormal pap test can also be the result of natural cervical cell changes (atrophic vaginitis) related to menopause. In some cases, untreated cervical cell changes that cause abnormal Pap tests may progress to precancerous or cancerous changes. The colposcopy will help determine if you need treatment and if so what kind of treatment will be most affective.

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How is it done?

Step One: Pre-Colposcopy instructions. You will be told by the doctor or nurse that for the few days before the exam to avoid vaginal intercourse. This is because seamen which stay in the body for up to 72 hours can interfere with the doctor’s ability to visualize the cervical cells. Also, if you start your period right before you are supposed to have a colposcopy it is important to call you doctor and reschedule. Menstrual bleeding will also have the same effect.

Step Two: The appointment. The day of your appointment you will sign in and get ready in the exam room just like you are having another pap smear. You will disrobe from the waist down and put on a drape.

Once you have your feet in the stirrups and are in position the doctor will insert a speculum – the curved instrument that holds the vaginal walls apart so that they doctor can see you cervix. This is exactly the same as a regular pelvic exam. Then the doctor will use a vinegar (acetic acid) or iodine (Lugol’s Solution) to make any areas of abnormal cells more visible to the eye and for the camera if the doctor has attached the camera to the colposcope.

Step Three: Abnormal Cell Biopsy. In some cases the doctor will look through the colposcope and see that there is really no problem. This means that the abnormality on the pap smear was not serious but they may recommend that you have your pap smears at more frequent intervals like every 6 months rather then a year. This will be determined by you doctor based on what is seen and your medical history.

However, if visible abnormalities look significant then your doctor may take small tissue samples directly from the abnormal areas they see. This is called a Biopsy. This can pinch and cause some discomfort – but it is important for proper diagnosis. If a biopsy is done there may be a little bleeding. A special solution (Monsel’s Liquid) or a nitrate swab may be used to stop the bleeding. If a sample is needed from inside the cervical opening then an endocervical curette will be used to take a sample of tissue from this area. Again this may cause cramping or discomfort – but it only lasts a minute.

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Usually this procedure lasts about 15 minutes.

Step Four: Aftercare

After the colposcopy you will probably feel fine. However if you had a biopsy, you may have some vaginal soreness for a day or two. A little bleeding or discharge is normal for up to a week after a biopsy. It also may be dark in color because of the solutions used during the biopsy. Use a sanitary pads for the bleeding. Do not douche, have sex, or use tampons for one week, to allow time for your cervix to heal and avoid exercise for one day after your colposcopy.

Follow any extra instructions your doctor gives you and Call your doctor if you have:

Heavy vaginal bleeding (more than a normal menstrual period).

A fever.

Belly pain.

Bad-smelling vaginal discharge.

Although colposcopy and cervical biopsy are very safe, there are always small risks of infection or bleeding so be aware of how you feel and any symptoms

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The Results – In the best case the doctor will not see any areas of abnormal cells during you test and you will not have to receive treatment.

The abnormalities seen during the test sores, genital warts or an infection, may be found in or around the vagina or cervix. If this is the case your doctor may prescribe medicine for you or other course of treatment.

If precancerous or cancerous cells are detected then you may need further procedures to remove these cells so that they do not spread causing more serious health issues.