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The Next Step: Colposcopy
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What is Colposcopy?
Colposcopy is done in the office. It usually takes about 15 to 20 minutes. It is best done when you are NOT having your period. We also recommend that you do not douche, use tampons, use vaginal medications, or have sex for 24 hours before the test.
Why is my doctor recommending I have a Colposcopy?
Colposcopy is done when a Pap test shows changes that could lead to cancer. It provides more information about abnormal cells. These abnormal cells may represent a pre-cancerous condition called dysplasia, which if not diagnosed or is left untreated may become cancerous. However, the Pap test is not always accurate and may report an abnormality when none are actually present. This is determined by colposcopy. Colposcopy also may be used to further assess certain problems: genital warts on the cervix, cervicitis (an inflamed cervix), benign growths (such as polyps), pain, or abnormal bleeding. Sometimes colposcopy may need to be done more than once. It also can be used to check the result of a treatment.
What should I expect during the Colposcopy?
As with a pelvic exam, you will lie on your back with your feet raised and placed on foot rests for support. A speculum will be used to spread apart the vaginal walls so that the inside of the vagina and the cervix can be seen. The colposcope is placed just outside the entrance of your vagina. A mild solution will be applied to your cervix and vagina with a cotton swab. This liquid makes abnormal areas on the cervix easier to see. You may feel a slight burning.
During the colposcopy, the doctor may see abnormal areas. To confirm these findings, your doctor may take some biopsies of these areas. A biopsy entails removing a small piece of tissue from the cervix to be sent to an outside pathology laboratory for analysis. Cells also may be taken from the canal of the cervix. Because the cells are not easy to see by the colposcope, a special device is used to scrape the cells. This scraping is called endocervical curettage (ECC). If biopsies are performed, it is generally done without anesthesia. Women often describe the biopsy procedure as feeling like moderate to severe menstrual cramps. Taking 3-4 Motrin or Advil prior to the procedure helps minimize the discomfort. A topical medication called Monsel’s solution is then applied to the cervix to help stop bleeding from the biopsies. It is a dark brown paste and may cause a brown-black discharge (may look like coffee grounds) for the next few days.
What causes these abnormalities of the cervix?
Cells on the cervix grow all the time, just like your skin. The cells at the bottom layer slowly move to the surface. Then they are shed. When this process changes in some way, cells become abnormal. The changes may go away on without treatment. However, changes may persist or progress and lead to cervical cancer.
Dysplasia and cervical cancer have been linked to a virus called Human Papillomavirus (HPV). This virus is most often passed during sex. The virus has many subtypes and these subtypes are categorized as low risk and high risk. It is believed that all cases of cervical cancer are caused by high-risk strains of the virus. But only a few women with a high-risk viral type will get cervical cancer. Unfortunately, we do not have any way to treat this virus. But we can treat the changes it may cause. It may cause changes in the cervix detectable by Pap smear and it may cause genital warts, also known as condyloma. Unfortunately, there is not an effective way to prevent transmission of the virus (condoms are only 60% protective). When we treat these abnormalities we are not treating the virus, therefore a woman still has the potential to have an abnormal Pap in the future and should continue to have Pap smears at the recommended interval.
When will I get the results of the Colposcopy?
If a biopsy was taken, it will be studied in the lab. When biopsy results come back from the lab, your doctor will discuss them with you. We recommend you schedule a follow-up appointment in two weeks to discuss your results. Colposcopy is done for the purpose of diagnosis only and is NOT considered a treatment. Depending on the results, you may need to be checked more often, or you may need further testing or treatments.
How long is the recovery after Colposcopy?
If you have a colposcopy without biopsy, you should feel fine right away. You can do the things you normally do. You may have a little spotting for a couple of days.
If you have colposcopy with biopsies, your vagina may feel sore for 1 or 2 days. You may have some vaginal bleeding. You may also have a dark discharge for a few days. This may occur from medication used to stop bleeding at the biopsy sites. You may need to wear a sanitary pad until the discharge stops.
Should I follow any special instructions after Colposcopy?
You should limit your activity for a brief time. While the cervix heals, do not have sex, take a tub bath, or douche for at least two days during this healing period.
When should I notify a doctor?
Call the office right away if you have any of these problems:
·heavy vaginal bleeding (soaking through more than one sanitary pad per hour)
·severe lower abdominal pain
·fever (more than 100.4°F), chills, or sweats
·bad smelling vaginal discharge
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