Colposcopy

What is Colposcopy?

Through a detailed examination of the cervix (neck of the uterus), precancerous conditions and cancer can be detected at a very early stage.

The most common methods for screening for cervical cancer are Papanicolaou (Pap) smear examination and Human papillomavirus (HPV) test. When a suspicious finding is encountered in these tests in terms of precancerous conditions, the cervix should be examined in detail. This method of examination is called colposcopy.

This procedure provides early diagnosis with high accuracy when performed by experts in the field.

Why is a colposcopy performed?

In the presence of abnormal cervical cancer screening test (smear and/or HPV test), colposcopy is recommended to make a diagnosis. Another reason for performing colposcopy is to investigate repeated vaginal bleeding after sexual intercourse.

During the examination, the neck of the uterus (cervix) is magnified up to 36 times and examined by colposcope. Meanwhile, some dyes are applied to determine the area (s) where abnormal cells on the cervix can be found. Depending on the size, type and location of these areas, a biopsy may be recommended at that time. The result of the biopsy will reveal whether there is actually a pre-cancerous lesion.

In many cases, the colposcopic examination will not reveal any abnormal findings and the patient is called for periodic follow-up examinations.

How To Prepare For Colposcopy?

Substances such as creams and vaginal suppositories should not be put in the vagina before colposcopy. If possible, colposcopy should be done when the patient is not on her period.

Your physician will ask about possible pregnancy status and whether you are taking a blood thinner medication (aspirin, coumadin, etc.) or not. Nevertheless, it is recommended to inform your physician about these issues beforehand. Colposcopy during pregnancy can be done safely.

How is a Colposcopy Done?

The whole procedure takes between 5 to 10 minutes and anesthesia is usually not required. It is done in a comfortable and relaxing environment. Before the procedure, the patient is informed in detail about the examination.

Colposcopy procedure basically consists of the following steps:

The patient is placed on a gynecological examination table and a speculum is inserted in the vagina.

The cervix is observed with a colposcope.

Vascularization (structure of the blood vessels) of the cervix is evaluated with a green filter.

With application of diluted acetic acid solution, the regions where the cells in the cervix tend to grow and protein production is increased are determined.

If available, biopsies (small tissue samples) are taken from areas where cancer precursors or cancer lesions are suspected. The part of the cervix facing the vagina (ectocervix) and the inside of the uterus (endocervix) can be sampled (endocervical curettage – ECC).

During the biopsy, there may be a slight cramping pain in your groin. This pain usually disappears in a short time.

Tissue samples are sent for pathological examination.

Further operations may be needed in cases where cancer or high risk of transformation into cancer in the future is found in tissue samples taken in colposcopic examination. If the risk of cancer in the tissues is low, the follow up of the patient is continued at clinically appropriate intervals.

What Precautions Should Be Taken After Colposcopy?

There may be light vaginal bleeding in the form of spotting.

There may be groin pain with mild cramps and it usually spontaneously disappears after a short time. Simple painkillers such as paracetamol can be used.

If a biopsy was taken, sexual intercourse should be avoided for about one week.

A shower can be taken at any time after surgery.


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