Colposcopy: What is it? Risks, Preparation, Procedure, Results and Complications

It is the direct augmented inspection of the surface of the woman’s genital area.

This inspection includes the cervix, vagina, and vulva, using a light source and a binocular microscope.

Doctors use the test to evaluate potentially cancerous areas, usually after a Pap smear has indicated the possibility of such a problem.

Your doctor may also perform a biopsy (take a sample) of an abnormal area during the procedure.

Colposcopy can also be used to detect inflammatory or infectious changes, harmless or cancerous tumors, and traumatic injuries to the cervix, vagina, and vulva.

Because the procedure is highly specialized, you need to make sure that your doctor has performed many of these tests.

Risks of colposcopy

The procedure is relatively safe. The main risks include bleeding, infection, and pelvic or abdominal pain. Colposcopy during pregnancy can cause complications with the pregnancy, including preterm delivery.

Although colposcopy greatly improves your doctor’s ability to sample diseased tissue, there is always the possibility that the doctor will not be able to determine the problem or be able to take biopsies of the appropriate area.

Preparation

Preparing for a colposcopy is similar to preparing for any gynecological exam.

You should schedule an exam when you are not menstruating.

Avoid douching, sexual intercourse, vaginal medications, and tampons for 24 hours before the exam.

If you are not allergic to acetaminophen (Tylenol, Panadol), your doctor may recommend taking something for pain 1 hour before the procedure. Aspirin or ibuprofen can also be used, but may increase bleeding from the procedure due to the antiplatelet effect of these medications.

Colposcopy procedure

You will be asked to remove your underwear, then you will lie on an exam table with your legs in stirrups. The procedure can take up to 30 minutes.

Inspection: Your doctor will insert a speculum into your vagina, using only water for lubrication, as lubricating jelly can interfere with the laboratory analysis of any samples obtained. The speculum will remain in place for the duration of the exam.

Your doctor will inspect your vagina and cervix with a magnified lens. An assistant may insert a small amount of saline solution (salt water) into the vagina to moisten the surface. The saline solution may feel cold.

Immediately after the inspection, an acetic acid preparation will be applied to your cervix. Acid may also feel cold, but it won’t burn. The doctor will re-inspect the vagina and cervix and decide whether to biopsy (take a tissue sample).

Special spots may be required to see certain areas of the cervix. The most common stain is an iodine solution, which may feel cold but won’t hurt.

Biopsy: If abnormalities appear, the doctor will perform a biopsy. You may feel a pinch and some discomfort for several seconds. The examiner may also perform an endocervical curettage.

Any samples obtained from these procedures will be sent to a laboratory for examination under a microscope.

After the procedure

After the colposcopy, you should wear a sanitary pad. Small amounts of bleeding can occur for 3-5 days. You can see dark, flowing material on the pad, sometimes green.

The fluid is normal because it is expelling the solutions used during the exam. However, you should avoid douching, intercourse, vaginal medications, or tampons until the bleeding stops.

Results

Your doctor uses various findings to determine the results of the procedure. Acetic acid causes abnormal areas on the cervix to stand out.

Biopsies undergo microscopic inspection in a pathology laboratory, often with special chemicals. A pathologist will determine normal cells from abnormal cells and send a report to your doctor.

You may need to wait several days for your lab results. Your doctor will discuss the findings with you during an office visit or over the phone. If you don’t have results within 2 to 3 weeks, call your doctor, unless other arrangements have been made.

When to seek medical care for colposcopy complications

Call your doctor if any of the following complications occur:

  • If you experience heavy bleeding (more than 1 pad every 2-3 hours), or if the bleeding lasts more than 5 days.
  • If you develop a fever, worrisome vaginal discharge, increased or continuous pelvic or abdominal discomfort for more than 24 hours after the exam.

With colposcopy, complications that require emergency care are rare. If you experience severe abdominal or pelvic pain, dizziness, uncontrolled bleeding, or fever, seek immediate help at the nearest hospital emergency department.