Colposcopy

Colposcopy is of value in examining women who have a suspicious or abnormal Pap smear. It allows for more specific and detailed examination of tissue than the general screening provided by the Pap smear.

The colposcope is an instrument that looks like a pair of binoculars, and is used in much the same way to magnify the tissues of the cervix. This enables the examiner to see minor changes in the color of these tissues and surface blood vessel patterns. These subtle differences help to distinguish healthy from abnormal tissue.

The colposcopic examination is much like a regular gynecologic examination. The speculum is inserted into the vagina and the cervix is visualized. The cervix and vagina will then be wiped with an acetic acid solution (vinegar and water). This will help to remove any mucus, which normally covers the cervix. The doctor then looks through the colposcope at the cervix to identify any changes that may be present. The colposcope itself remains outside of the vagina.

If suspicious areas are identified, a biopsy (small tissue sample) is taken and sent to a pathologist for microscopic examination. If left untreated, many abnormal areas would go away on their own, but some could progress to a more serious problem. Since we cannot determine which will get worse, we recommend that all abnormalities either be treated or closely followed. Treatment options are varied. Your doctor will explain them and discuss the best treatment for you. Some of the possibilities include cryosurgery (freezing), loop electrical excision of the abnormal areas, or simply follow-up colposcopy. All of these treatments have a significant success rate.

The biopsy is a sharp sensation, but very brief. Some patients notice menstrual-type cramping after a cervical biopsy. Therefore we recommend that about an hour before the colposcopy you use ibuprofen (Motrin, Nuprin, Advil, or Aleve) if you are not allergic to aspirin products. We recommend that you avoid intercourse (nothing in the vagina) for one week after colposcopy (when biopsies are taken).

Generally, biopsy results come back to our office in about 1-2 weeks. Your doctor will review these results, and will notify you of any further instructions either by letter or phone. Insurance companies consider colposcopic examination with biopsy a surgical procedure, and you will receive a separate bill from the pathologist for the microscopic tissue examination.

On the day of your colposcopy, you will have the opportunity to ask questions. We encourage you to write down your questions ahead of time, so that you will remember what you want to ask your doctor.

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