What is a Colposcopy?
A colposcopy is a means of examining the vagina, cervix, and vulva with a large, electric microscope called a colposcope. A colposcopy is typically conducted if a patient receives abnormal Pap smear results.
If the physician notices any abnormal areas, they will take a tissue sample and send the samples to a lab for a pathological examination.
Some patients feel uneasy when their doctor recommends a colposcopy, however, understanding the test and what to expect can ease a patient’s nerves. Colposcopies are a generally quick procedure with minimal discomfort.
Why Are Colposcopies Performed?
A gynecologist may suggest a colposcopy if the patient:
● has abnormal Pap smear results
● is experiencing bleeding after intercourse
● has an abnormal growth visible on their vagina, cervix, or vulva.
A colposcopy can be used to diagnose:
● genital warts
● cervicitis (inflammation of the cervix)
● abnormal cervical cells, or precancerous cells
How Do Patients Prepare for a Colposcopy?
There isn’t much to do to prepare for this examination. However, there are a few things patients should keep in mind:
● Ask their doctor to thoroughly explain the test.
● Tell their gynecologist if they think they might be pregnant.
● Schedule the test for a time when they aren’t menstruating heavily.
● Patients should try to empty their bladder and bowels before the test to make it more comfortable.
● Patients shouldn’t douche, use tampons, or have sexual intercourse for 24-48 hours preceding the exam.
● Some doctors recommend a mild over-the-counter pain reliever before the test in case they will take biopsies. Patients should discuss this with their doctor prior to the day of the test.
How is a Colposcopy Performed?
A colposcopy requires no anesthetic, is typically performed in a doctor’s office, and takes about 10-20 minutes. If a patient feels anxious during the test, they should concentrate on taking slow, deep breaths to relax their body.
Here’s what patients can expect:
● Patients lie on their back on an examination table with their feet in stirrups, like during a pelvic exam or Pap smear.
● The doctor positions the colposcope a few inches away from the vulva and places a speculum into the vagina. The speculum holds the walls of the vagina open so that the doctor can see the cervix. This isn’t supposed to be painful but some women find the speculum insertion uncomfortable.
● The vagina/cervix is cotton swabbed with a solution of vinegar to clear mucus and highlight irregular cells. This step is also supposed to be painless but some patients experience a stinging sensation from the vinegar solution.
● The colposcope doesn’t actually touch the patient. Any area that is abnormal may be photographed and/or biopsied.
● After the biopsy, Monsel’s solution is often applied to help control bleeding. There’s often a dark-colored discharge that lasts for several days following the procedure.
Biopsy Accompanying a Colposcopy
If a patient has a biopsy, how the procedure feels will depend on the location being tested:
A colposcopy is generally painless, however, having a cervical biopsy may induce cramping, discomfort, bleeding, and pain for some patients.
A patient’s doctor may suggest they take a pain reliever 30 minutes prior to the procedure or numb the patient’s cervix prior to the biopsy. Patients should collaborate with their doctor about the best plan of action.
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 in that area before proceeding.
What Are the Risks of a Colposcopy?
The risks following a colposcopy and biopsy are minimal, but rare complications can include:
● pelvic pain
● fever or chills
● vaginal infection
● bleeding that is very heavy or lasts more than two weeks
A patient experiencing any of these symptoms should inform their doctor immediately. A common misconception is that a colposcopy and biopsy can make it more difficult for the patients to become pregnant but this is not true.
What Do the Results of a Colposcopy Mean?
Patients should ask their doctor when they can expect the test results and follow-up with their doctor if they don’t receive their results in a timely manner.
The results will help the doctor and patient determine if the patient needs any additional tests or treatment.
If the test results are normal, the doctor may recommend additional testing or a follow-up exam to see understand why the Pap smear was abnormal.
Abnormal Biopsy Results
A pathologist will examine the tissue samples obtained from the biopsy and check for abnormalities in those samples.
Biopsy results can assist doctors in diagnosing abnormal cervical cells, precancer, cancer, and other treatable conditions. Health care providers will make recommendations based on the results of both the colposcopy and biopsy. Patients should schedule time with their doctor to have all of their questions answered and shouldn’t hesitate to seek a second opinion.
What Happens After a Colposcopy?
After a colposcopy, patients may experience dark vaginal discharge for up to three days, and/or bleeding for up to a week. They also may experience vaginal soreness and mild cramping for 1-2 days.
If no biopsy was taken, the patient may resume normal activity right away.
If the patient has had a biopsy, they should avoid tampons, douches, vaginal creams, and vaginal intercourse for a week, however, they can immediately shower or bathe as usual. We encourage patients to discuss any concerns directly with their doctor.
Patients should continue regular gynecological exams and Pap smears, as directed, regardless of the results.