Colposcopy is a diagnostic procedure that helps to obtain a magnified view of the cervix using a telescopic camera which is held outside the patient and the images are visualised on a monitor. This helps to localise the abnormal area on the cervix which may be shedding the abnormal cells, and hence take a targeted biopsy. Generally colposcopy follows a Pap smear when the Pap smear shows abnormal cells, but may also need to be done if there is bleeding during intercourse, between periods or when the cervix is abnormal looking on naked eye examination.
PROCEDURE
Patient is made to lie on a table. Instead of looking at the cervix with naked eye, a colposcope is used. This has a light source which gives bright light over a focussed area and a magnifying lens which can magnify the view up to 40 times. This makes looking at the vascular architecture and lesion characteristics much easier. Saline, dilute vinegar (acetic acid) and iodine based solutions are applied in succession to the cervix and the cervix examined with colposcope after each application. All these help to better delineate any abnormal area and grade its severity. Based on this, a biopsy may be taken from the cervix if required. The procedure does not require anesthesia or sedation though sedation may be used in some cases when a biopsy is being taken. Colposcopy can also be used to inspect the vagina and vulva in some cases.
DURATION
It may take between 15-30 minutes, and longer if a biopsy is needed.
RECOVERY
Since no anesthesia is used, the patient is up and about immediately. In case a colposcopic biopsy is taken, recovery depends on the nature of the biopsy. Detailed instructions regarding do's and dont's will be explained by the gynaecologist.
RISKS
Colposcopy without biopsy also does not have any major risks, although there may be the rare woman who is allergic to iodine. If you have a known allergy, inform your gynaecologist beforehand. Some women experience a mild stinging with dilute vinegar which passes off shortly.
The risks of biopsy are bleeding, infection, discharge, pain and rarely injury to internal organs.
Contributed by:
Dr Pakhee Aggarwal
MS (Obs & Gyn), MICOG, MRCOG (UK), Fellowship Gynae-Oncology (Oxford)
Consultant Obstetrician, Gynaecologist & Colposcopist