Colposcopy and cervical biopsy for abnormal Pap test

Your gynecologist may order a colposcopy if your cervix appears abnormal during your pelvic exam and Pap smear, or if you have a history of prenatal DES exposure.

Colposcopy is a simple, 10- to 15-minute procedure that is painless and performed in a gynecologist’s office. You are positioned on the examination table like you are for a Pap smear, and an acetic acid (such as common table vinegar) is placed on the cervix.

Your physician will use a colposcope — a large, electric microscope that is positioned approximately 30 cm from the vagina — to view your cervix. A bright light on the end of the colposcope lets the gynecologist clearly see the cervix.

During the initial evaluation, a medical history is obtained, including gravidity (number of prior pregnancies), parity (number of prior deliveries), last menstrual period, contraception use, prior abnormal pap smear results, allergies, significant past medical history, other medications, prior cervical procedures, and smoking history. In some cases, a pregnancy test may be performed before the procedure. The procedure is fully described to the patient, questions are asked and answered, and the patient then signs a consent form.

A colposcope is used to identify visible clues suggestive of abnormal tissue. It functions as a lighted binocular microscope to magnify the view of the cervix, vagina, and vulvar surface. Low power (2× to 6×) may be used to obtain a general impression of the surface architecture. Medium (8× to 15×) and high (15× to 25×) powers are utilized to evaluate the vagina and cervix. The higher powers are often necessary to identify certain vascular patterns that may indicate the presence of more advanced pre-cancerous or cancerous lesions. Various light filters are available to highlight different aspects of the surface of the cervix. Acetic acid solution and iodine solution (Lugol’s or Schiller’s) are applied to the surface to improve visualization of abnormal areas.

After a complete examination, the colposcopist determines the areas with the highest degree of visible abnormality and may obtain biopsies from these areas using a long biopsy instrument, such as a punch forceps or SpiraBrush CX. Most doctors and patients consider anesthesia unnecessary; however, some

A cervical biopsy is a procedure to remove a sample of the cervix so the tissue can be examined under a microscope.

The amount of cervical tissue removed depends on the method used.

• A simple cervical biopsy, sometimes called a punch biopsy, removes a small piece of tissue from the surface of the cervix.
• An endocervical biopsy (endocervical curettage) removes tissue from high in the cervical canal by scraping with a sharp instrument.
• Loop electrosurgical excision procedure (LEEP) uses a thin, low-voltage electrified wire loop to cut out abnormal tissue.
• A cone biopsy (conization) is a more extensive form of a cervical biopsy that removes a cone-shaped wedge of tissue from the cervix.

It is recommended that woman not have sex or douche 24 to 48 hours before a colposcopy/biopsy. These activities can cause inaccurate results.

You may feel some discomfort when the vaginal speculum is inserted. You may feel a pinch and have some cramping if a biopsy sample is taken.

After the test

If you have a biopsy, you may feel some soreness in your vagina for a day or two. Some vaginal bleeding or discharge is normal for up to a week after a biopsy. The discharge may be dark-colored if Monsel’s solution was used. You can use a sanitary pad for the bleeding. Do not douche, have sex, or use tampons for one week, to allow time for your cervix to heal. Do not exercise for one day after your colposcopy.

Follow any instructions your doctor gave you. Call your doctor if you have:

• Heavy vaginal bleeding (more than a normal menstrual period).
• A fever.
• Belly pain.
• Bad-smelling vaginal discharge.

A cervical biopsy is normally performed during a colposcopy. A colposcopy is a procedure that allows the doctor a more in-depth examination of the cervix. After the doctor has identified any abnormal areas of the cervix, small amounts of tissue are taken with biopsy forceps or needle.

The information provided on this site is intended to educate the reader about certain medical conditions and certain possible treatment. It is not a substitute for examination, diagnosis, and medical care provided by a licensed and qualified health care professional. If you believe you, or someone you know suffers from the conditions described herein, please see your health care provider immediately. Do not attempt to treat yourself or anyone else without proper medical supervision.