Detailed evaluation of the lower genital tract, primarily the cervix, with a special microscope in women with abnormal smear or HPV results. A biopsy is taken when needed.
Indication
- Abnormal cervical smear (Pap test) result (ASC-US, LSIL, HSIL, AGC, etc.)
- High-risk HPV positivity (especially HPV 16/18)
- Visible suspicious lesion on the cervix, chronic discharge or recurrent bleeding
- Follow-up of patients previously diagnosed with CIN/dysplasia
- Unexplained gynecologic complaints such as postcoital bleeding or postmenopausal bleeding
Preparation
- The procedure is planned, when possible, on days without menstrual bleeding
- Avoidance of vaginal douching, tampons and sexual intercourse 24-48 hours before the procedure
- Any vaginal medication or cream use should be reported to the physician
- A suspected pregnancy must be disclosed; colposcopy can be performed during pregnancy and the biopsy decision is made carefully
- Aspirin/blood thinner use requires physician approval
How it's performed
- The patient is positioned on the gynecologic examination table and a speculum is inserted
- Acetic acid (similar to vinegar) and, if needed, Lugol's solution are applied to the cervix
- Abnormal areas on the cervix are evaluated with a magnifying device called a colposcope
- Small tissue samples (biopsy) may be taken from suspicious areas with fine forceps
- If needed, a sample is also taken from the endocervical canal (ECC)
- Bleeding is controlled and Monsel's solution is applied if necessary
Post-procedure
- A short rest after the procedure is sufficient; most patients return to daily life on the same day
- Spotting or dark-colored discharge may occur for a few days; sanitary pads are recommended instead of tampons
- If a biopsy was taken, restriction of sexual intercourse, vaginal douching and tampons for 1-2 weeks
- An evaluation appointment with the physician is scheduled when the pathology result is ready
- Depending on the diagnosis, a follow-up smear, HPV test or treatment (LEEP/conization) is planned
Risks
- Mild cramping or pressure sensation
- Spotting or light bleeding for a few days after biopsy
- Vaginal/pelvic infection (rare)
- Temporary discharge and tenderness
- When performed during pregnancy, very rare risk of preterm labor (done with strict indication)
FAQ
Is colposcopy a painful procedure?
The procedure is generally not painful; mild pressure may be felt when the speculum is placed and a brief burning sensation when acetic acid is applied. When a biopsy is taken, a short pinching or cramping pain may be experienced.
Does an abnormal smear result mean I have cancer?
No. The majority of abnormal smear results are not cancer but rather precursor lesions (CIN) or infection-related changes. Colposcopy is the next step taken to make the actual diagnosis and assess the risk.
When are the results available?
Only the visual evaluation result can be shared during the procedure. Pathology results from the biopsy usually take 7-14 days; afterwards the physician sees you again to explain the follow-up or treatment plan.
Will colposcopy prevent me from getting pregnant?
Colposcopy alone does not negatively affect pregnancy. Sexual intercourse should only be avoided for 1-2 weeks after a biopsy. If further treatment (LEEP, conization) is needed, possible effects on a future pregnancy will be discussed separately with your physician.
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