What is Colposcopy?
- Colposcopy is the direct magnified inspection of the surface of a woman’s genital area, including the cervix, vagina, and vulva, using a light source and a binocular microscope.
- Doctors use the test to evaluate potentially cancerous areas, typically after a Pap smear has indicated the possibility of such a problem.
- Your doctor also may perform a biopsy (take a sample) of an abnormal area during the procedure.
- Colposcopy also can be used to detect inflammatory or infectious changes, harmless or cancerous growths, and traumatic injuries to the cervix, vagina, and vulva.
- Because the procedure is highly specialized, you should make sure that your doctor has performed many such examinations.
Although colposcopy greatly improves your doctor’s ability to sample diseased tissue, there always is a chance the physician may not be able to determine the problem nor be able to take biopsies from the appropriate area.
Preparation 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 some for pain 1 hour before the procedure. Aspirin or ibuprofen may also be used, but may increase bleeding from the procedure due to these drugs' anti-platelet effect.
During the Colposcopy Procedure
You will be asked to remove your undergarments, then you will lie on an examination table with your legs placed in stirrups. The procedure may last up to 30 minutes.
- Inspection: Your doctor will insert a speculum into your vagina, using only water for lubrication, because lubricating jelly may interfere with the laboratory analysis of any specimens obtained. The speculum will remain in place for the duration of the exam.
- Your doctor will inspect your vagina and cervix using a magnified lens. An assistant may insert a small amount of saline solution (salt water) into the vagina to moisten the surface. The saline may feel cool.
- Immediately following the inspection, an acetic acid preparation will be applied to your cervix. The acid also may feel cool, but will not burn. The doctor then will reinspect your vagina and cervix and will decide whether to perform a biopsy (take a tissue sample).
- Special stains may be required to see certain areas in the cervix. The most common stain is an iodine solution, which may feel cool but will not hurt.
- Biopsy: If any abnormalities appear, the doctor will take a biopsy. You may feel a pinch and some discomfort for several seconds. The examiner also may perform an endocervical curettage—a gentle scraping of the cervical canal that may cause a cramping sensation. Any specimens obtained from these procedures then will be sent to a lab for examination under a microscope.
After the Colposcopy Procedure
Following the colposcopy, you should wear a sanitary pad. Small amounts of bleeding may occur for 3-5 days. You may see on the pad dark, fluid material, sometimes green, resembling coffee grounds. The fluid is normal because you are expelling the solutions used during the exam. However, you should avoid douching, sexual intercourse, vaginal medications, or tampons until the bleeding stops.
Next Steps after Colposcopy
Your doctor uses several findings to determine results of the procedure. The acetic acid causes areas of abnormality on the cervix to stand out. Biopsies undergo microscopic inspection at a pathology lab, often with special chemicals. A pathologist will determine normal cells from abnormal cells and send a report to your doctor.
You may have to wait several days for lab results. Your doctor will discuss the findings with you either during an office visit or by telephone. If you do not have the results within 2-3 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 occur:
- If you experience heavy bleeding (more than 1 pad every 2-3 hours), or if bleeding lasts more than 5 days
- If you develop a fever, worrisome vaginal discharge, or increasing or continued pelvic or abdominal discomfort for longer than 24 hours after the exam
With colposcopy, complications requiring emergency care are rare. If you experience severe abdominal or pelvic pain, dizziness, uncontrolled bleeding or fever, seek immediate help at the nearest hospital's emergency department.
Medically reviewed by Martin E. Zipser, MD; American board of Surgery
"Patient information: Colposcopy (Beyond the Basics)"