Colposcopy Examination
Examining Abnormalities In The Cervix And Vagina

medical tests for women


Colposcopy Test


What Is A Colposcopy?
When Is A Colposcopy After A Pap Test Necessary?
When Else Is A Colposcopy Used?
How Do I Prepared For A Colposcopy?
How Is It Performed?
What Are The Risks?
What Do The Results Mean?
Colposcopy In Pregnancy

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What Is A Colposcopy?

A colposcopy is a medical technique for examining the cervix and vagina using a magnifying instrument called a colposcope. Colposcopies are generally only done if a Pap smear test comes back with an abnormal result. Some types of gynecological cancers, such as cervical cancer and vaginal cancer can be detected through this examination. When cancer or precancer changes are suspected, a tissue sample can be taken for biopsy. Biopsies done by colposcopy are particularly accurate because the colposcope magnifies inside the vagina by 5 to 30 times. This allows the gynecologist to find and remove a sample of the most abnormal looking tissue for biopsy. Furthermore, colposcopy-guided biopsies are less risky and less expensive than surgical procedures like cone biopsy.

When Is A Colposcopy Necessary After A Pap Test?

A pap smear test is a routine health screening women have to check for signs of cervical cancer. It may also be referred to as cervical screening. During the pap test, a sample of cells are taken from the cervix and sent to a lab for testing. In a small number of cases abnormal cervical cells (technically called cervical dysplasia) are found. In most instances the abnormalities are caused by the presence of an STD called human papilloma virus (HPV). Regular screening helps ensure that any such changes are detected early, and treated if required before they have a chance to turn cancerous. About 1 in 10 pap tests reveal abnormal cell changes. 1 in 20 of these are mild and require no treatment because they return to normal by themselves. Your pap test will reveal if HPV is present, and if so, which strain (some are more high risk than others). If your test shows mild cell changes plus high risk HPV you will be referred for a colposcopy as a precaution. If it shows mild changes and low risk HPV, you won't need a colposcopy. If there are moderate or severe cell changes, regardless of HPV status, you will need a colposcopy.

When Else Is A Colposcopy Used?

The main goal of colposcopy is to detect cervical cancer in it's early and most curable stages. However, it may also be used to investigate:

• Unexplained bleeding, such as after sexual intercourse.
• Unexplained pelvic pain or an inflamed cervix (cervicitis).
• Benign growths called cervical polyps.
Genital warts found on the cervix.

It can also be used to assess:

• Women whose mothers took the drug DES when they were pregnant with them. Read about the causes of cervical cancer for more.
• Rape victim for forensic examination.

How Do I Prepared For A Colposcopy?

1. Schedule a colposcopy when you don't have a period. The best time is 8 to 12 days after the first day of your last period.
2. Empty your bladder before the test.
3. Some doctors ask women to put estrogen creams into the vagina several days before a colposcopy to further highlight areas of cervical tissue changes.

For 24 hours before the procedure avoid:
4. Sexual intercourse
5. Using tampons
6. Douching
7. Vaginal hygiene products like deodorant sprays and powders
8. Vaginal creams, medicines or suppositories

How Is It Performed?

A colposcope is performed in your gynecologist’s office and takes about 20 minutes. The patient lies on her back, with her legs in stirrups and her buttocks at the lower edge of the table (known as the dorsal lithotomy position). The doctor examines the vulva first for any suspicious lesions and then places a speculum inside the vagina. The speculum opens the vagina, and keeps it open so that the doctor can work. Next the vagina and cervix is washed with acetic acid (smells like vinegar). The colposcope is moved close to the entrance of the vagina, it never enters the body. Through this instrument the doctor will look for any abnormalities. A small tissue sample may be removed for biopsy. The procedure does not hurt, although some women find the speculum uncomfortable after a period of time.

What Are The Risks?

There are no serious risks or complications associated with colposcopy. If a biopsy is performed there may be some minor spotting or cramping. There is also a risk of urinary tract infection.

What Do The Results Mean?

It can take 2 to 3 weeks for your biopsy results (colposcopic findings) to come back. When they are ready your doctor will call you back in to discuss the results and possible treatments. From this point onwards he will start to refer to your dysplasia as cervical intraepithelial neoplasia (or CIN for short!). There are 3 categories of CIN, your biopsy result will show which one you have:

CIN I: Mild dysplasia.
CIN II: Moderate to marked dysplasia.
CIN III: Severe dysplasia to carcinoma in situ. Without treatment 30 to 50 percent of CIN III cases turn into cancer. The risk is much lower for milder dysplasia. The next stage after CIN III is cervical cancer (see stages of cervical cancer).

To find out more about treatment, see cervical dysplasia.

Colposcopy In Pregnancy

A colposcopy is safe to perform in pregnancy. See cervical changes in pregnancy for more information.

  Related Articles on Diagnostic Testing

For more on useful information, see the following:

Reproductive system disorders: A to Z of symptoms.
Cervical cancer diagnosis: Tests and procedures.
Vaginal cancer diagnosis: Examinations and tests.
Hospital departments explained: Find your way around hospitals.

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