Colposcopy: what é, what it is for and how é done

2023 Author: Benjamin Dyson | [email protected]. Last modified: 2023-05-27 20:34

Colposcopy is a gynecological examination in which the vulva, vagina and cervix are observed in a very detailed way, looking for signs that may indicate inflammation or diseases such as HPV and cancer.

Generally, the gynecologist performs this exam when, during the gynecological exam, lesions are seen in the cervix or vagina or when the pap smear showed some alteration.

This exam is simple and doesn't hurt, but it can cause a little discomfort and a burning sensation when the gynecologist applies products that help to better observe the cervix and vagina. During the examination, if the doctor checks for the presence of any suspicious changes, he may collect a sample for a biopsy.

What is it for

Colposcopy is indicated to observe the vulva, vagina and cervix in more detail, this exam can be performed for:

• Investigate inflammation of the cervix, called cervicitis;
• Identify benign polyps;
• Identify lesions indicative of cervical cancer;
• Investigate the cause of excessive and/or unspecific vaginal bleeding;
• Check the presence of precancerous lesions in the vagina and vulva;
• Investigate the cause of pelvic pain;
• Analyze genital warts or other lesions that can be identified visually.

Colposcopy is usually indicated after an abnormal Pap smear result, however it can also be requested as a routine gynecological examination, and can be performed together with the Pap smear. Understand what it is and how the Pap smear is performed.

How colposcopy is performed

Colposcopy is a simple and quick exam in which the woman needs to be in a gynecological position for the procedure to be performed. Then, the gynecologist will take the following steps to perform the colposcopy:

1. Introduction of a small instrument called a speculum into the vagina, the same used in routine gynecological examination, to keep the vaginal canal open and allow a better observation of the cervix;
2. Place the colposcope, which is a type of microscope that looks like a binocular, in front of the woman to allow a close-up, detailed view of the wall of the vagina, vulva, and cervix uterus;
3. Apply different products to the cervix if necessary, such as acetic acid, to eliminate mucus and allow better visualization of the cervix, or Lugol's solution or solution Schiller, to identify changes in the region. It is during this time that the woman may feel a little burning.

Furthermore, during the procedure the doctor can also use the instrument to take enlarged photographs of the cervix, vulva or vagina for inclusion in the final examination report.

Colposcopy with biopsy

In case alterations are identified during the examination, the doctor may collect a small sample of the region so that the biopsy can be performed, thus making it possible to know whether the identified alteration is benign or malignant and, in this case, possible to initiate appropriate treatment. Understand how the biopsy is performed and how to understand the result.

Is it possible to do colposcopy during pregnancy?

Colposcopy can also be performed normally during pregnancy, as it does not cause any harm to the fetus, even if the procedure is performed with biopsy.

If any changes are identified, the doctor will assess whether the treatment can be postponed until after delivery, when a new examination will be carried out to assess the evolution of the problem.

How to prepare for the exam

To perform the colposcopy, some precautions must be taken, such as:

• Tell the doctor about the use of anticoagulant drugs, such as warfarin, heparin, rivaroxaban or acetylsalicylic acid, as they may increase the risk of bleeding if a biopsy is performed;
• Do not have sexual intercourse for 48 hours before the exam, even if using a condom;
• Do not use tampon, vaginal douche, creams or other vaginal medications for 24 hours before the exam;
• Not menstruating, unless the test has been ordered to investigate the cause of excessive and/or nonspecific vaginal bleeding;
• Empty the bladder, immediately before the exam,
• Inform the doctor if you are allergic to iodine, as Schiller's solution and Lugol's solution contain iodine in their composition;
• Inform the doctor if you are allergic to other medications or latex, for example;
• Take your usual medication, as directed by your doctor.

Furthermore, in order to avoid pain or discomfort during the colposcopy, the doctor may recommend that the woman take an analgesic, such as ibuprofen, approximately 30 to 60 minutes before the exam.

It is also recommended that the woman bring the result of the last Pap smear or another that she has had recently, such as a transvaginal ultrasound, abdominal ultrasound or blood tests.

How to understand the result

During the colposcopy, the gynecologist must inform if he found any alteration in the cervix, vagina or vulva, and if alterations were seen, perform the biopsy.

The result of colposcopy with biopsy is interpreted by the gynecologist, which may indicate the presence of altered cells in the region where the biopsy was performed. In this case, depending on the degree of change in the cells, the doctor can indicate the most appropriate treatment. Find out how cervical cancer is treated.

Care after colposcopy

Colposcopy is a quick exam and lasts about 15 to 20 minutes, and after the exam, pain or discomfort in the vagina or vulva may occur, for about 1 to 2 days, due to the use of the speculum or applying the products to the cervix.

In addition, if colposcopy with biopsy was performed, cramping, light bleeding, or brown discharge may occur. In this case, you should avoid having sex or using vaginal douches or tampons for 1 week after the exam to allow the cervix to heal.

Possible exam complications

Colposcopy is a safe test, usually causing no complications during the procedure. However, in some cases, especially when colposcopy with biopsy is performed, excessive vaginal bleeding, foul-smelling discharge, severe cramping, fever, or chills may occur.

In these cases, it is important to contact the gynecologist immediately or go to the nearest emergency room, as it may be indicative of infection.