Ask the Expert: Colposcopy

Q. What is it?
A. An examination of a woman’s vagina and cervix vagina and cervix using a special instrument with a light source and magnifying lenses using a colposcope.  It allows your health care provider to see the cervix and vagina for cancer and abnormal areas that may become cancer.  The procedure takes about 15-30 minutes and doesn’t require anesthesia.

Q. What is it used for?
A. To check for cervical cancer or precancerous changes after you’ve had an abnormal Pap test, or as a follow-up to view an abnormal area seen during an earlier exam.  During this exam, your health care provider can remove a sample of tissue from the cervix for testing, called a biopsy.

Q. Preparation
A. Don’t take aspirin for about a week before the procedure.  Don’t douche or use vaginal creams or medications the day before the procedure.  Because you will need to remove your clothing from the waist down, try to wear a two-piece outfit with slacks or a skirt.  Also, because you might have a very small amount of bleeding from the procedure, or if you had a biopsy, from that, so bring a sanitary pad to wear afterwards.

Be sure to tell your health care provider about all the medications you take.  Also, it is very important to let your health care provider know if you’re pregnant.  Don’t stop using birth control before the procedure.

Because your period may make it more difficult to see inside the vagina, try to plan having the procedure when you’re not having your period.  If your period starts and you know you will still be bleeding the day of the procedure, then call your health care provider.

Q. How is it done?
A. Remove your clothing from the waist down. Cover yourself with the drape from the waist down. You will lie on your back on the exam table or chair with legs spread, knees bent, and heels placed in stirrups. A lubricated instrument, called a speculum, will be inserted into your vagina (like when you get a Pap test).  Sometimes, the vagina and cervix will be rinsed with a vinegar or iodine solution to make abnormal areas easier to see.

The colposcope (it looks like a microscope’s eye pieces) will be moved close to the outside of your body, and your health care provider will look through it at your cervix and vagina.  Sometimes pictures may be taken, and sometimes a computer screen will be positioned so you can see what the provider is seeing and doing.  If necessary, a small piece of tissue, called a biopsy, will be removed from an area that looks abnormal. It will feel like a little bee sting, and may cause some temporary mild cramping or a little discomfort.  If you take over-the-counter Ibuprofen before the procedure (or Advil or Motrin), it may help cut down on any discomfort.

The tissue removed will be sent to the lab’s pathologist for examination, and the health care provider should have the results in about 1-2 weeks.

Q. Follow Up
A. You can return to all of your normal activities right away, that same day.  Most health care providers recommend not having sex for at least 1-2 weeks, or if you’re bleeding, until the bleeding stops. 

If you had a biopsy, you may have mild bleeding but should have little or no pain.  Call your health care provider for your results if you haven’t heard anything in 2 weeks.  Keep in mind additional treatment may be necessary, especially if anything abnormal is found.

Q. Risks
A. There is a very small risk of infection or heavy bleeding, but generally it is a safe and painless procedure. 

Q. When to call a professional
A. Call right away if vaginal bleeding becomes heavy (using 1-2 pads every 2 hours or less).  Call if you have pelvic pain or discomfort, fever or a discolored and foul-smelling discharge.

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