Colposcopy is a procedure that uses an instrument with a magnifying lens and a light, called a colposcope, to examine the cervix (opening to the uterus) and vagina for abnormalities. The colposcope magnifies the image many times, thus allowing the physician to see the tissues on the cervix and vaginal walls more clearly. In some cases, a cervical biopsy, a small sample of tissue, may be taken for further examination in the lab.

Reasons for Colposcopy

When cervical or vaginal problems are found during a routine pelvic examination, or abnormal cells are found during a Pap test, a colposcopy may be performed. Through the colposcope, the physician can see certain changes in cervical and vaginal tissues such as abnormal blood vessels, tissue structure, color, and patterns. The appearance of these abnormal cells may be the first evidence of cancer that develops years later.

If abnormal tissue is seen during a colposcopy, a small sample of tissue (called a colposcopic biopsy) may be taken for further study.

A colposcopy procedure may also be used to diagnose and assist in the treatment of the following conditions:

  • Bleeding
  • Polyps (benign growths)
  • Genital warts, which may indicate infection with human papilloma virus (HPV), a risk factor for developing cervical cancer
  • Diethylstilbestrol (DES) exposure in women whose mothers took DES during pregnancy, as DES exposure increases the risk for cancer of the reproductive system

There may be other reasons for your physician to recommend colposcopy.

Ideally, a colposcopy procedure should be scheduled approximately one week after your menstrual period. The colposcopy may be performed in your physician’s office, on an outpatient basis, or as part of your stay in a hospital.

About the Procedure

Generally, a colposcopy follows this process:

  • You will be asked to undress completely or from the waist down and put on a hospital gown.
  • You will be instructed to empty your bladder prior to the procedure.
  • You will lie on an examination table, with your feet and legs supported as for a pelvic examination.
  • Your physician will insert an instrument called a speculum into your vagina to spread the walls of the vagina apart to expose the cervix.
  • The colposcope, which is like a microscope with a light on the end, will be placed at the opening of your vagina. The colposcope does not enter your vagina.
  • Your physician will look through the colposcope to locate any problem areas on the cervix or in the vagina. Photographs with the colposcope or sketches of any areas may be made for your healthcare record.
  • Your cervix may be cleansed and soaked with a vinegar solution, also called an acetic acid solution. This solution helps make the abnormal tissues turn white and become more visible. You may feel a mild burning sensation. An iodine solution may be used to coat the cervix, called the Schiller test.
  • Your physician may take a small tissue sample called a biopsy. When this is done, the physician first numbs the area but you may feel a slight pinch or cramp as the tissue is removed.
  • Cells from the inside of the cervical canal may be sampled with a special instrument called an endocervical curette. This may also cause some cramping.
  • Bleeding from the biopsy site may be treated with a paste-like topical medication or with a pressure dressing.
  • The tissue will be sent to the lab for examination.

After the Colposcopy

Your physician will advise you on when to return for further treatment or care. Generally, women who have had a cervical biopsy will need more frequent Pap tests.

Notify your physician if you have any of the following:

  • Bleeding
  • Foul-smelling drainage from your vagina
  • Fever and/or chills
  • Severe pelvic (lower abdominal) pain 

Your physician may give you additional or alternate instructions after the procedure, depending on your particular situation. 

Quality, Affordable Care

Patients seen in the ambulatory clinics are offered financial counseling services and assistance in obtaining insurance coverage through Medicaid if needed.

To learn more about colposcopy, contact a North Shore-LIJ gynecologist or request an appointment today.