Colposcopy, a diagnostic tool and why it is recommended
Colposcopy is a diagnostic tool that allows us to better evaluate abnormal PAP smears. The Pap smear is the most common screening test performed to check for abnormalities of the cervix. If a Pap smear indicates that changes have occurred on the surface of the cervix that may be pre-cancerous, the cervix is better evaluated by colposcopy. A colposcope is similar to a powerful magnifying glass that gives us a close-up view of the surface layer of the cervix.
HOW IS COLPOSCOPY PERFORMED
When performing colposcopy, a speculum is placed into the vagina. The cervix is wiped clean with a large Q-tip and the cervix is then painted with acetic acid (vinegar). You may notice a mild burning sensation after application of acetic acid. The colposcope is then used to examine the cervix. Acetic acid makes abnormal cells more visible during colposcopy by dehydrating them. When the cells are dehydrated, they turn white and are seen more easily when looked at through the colposcope’s green filter. If an abnormal area of the cervix is identified, a small piece of the lining of the cervix is biopsied (you’ll feel a little pinch) and sent to a Pathologist for further evaluation. Results will be available in approximately one (1) week. Medication prior to the colposcopy is rarely necessary, as the procedure is quick and relatively painless. HOWEVER, IF YOU HAVE MITRAL VALVE PROLAPSE, YOU WILL NEED TO TAKE PROPHYLACTIC ANTIBIOTICS. PLEASE LET US KNOW BEFORE WE BEGIN.
BENEFITS, RISKS AND ALTERNATIVES
The benefit of this procedure is that, unlike the Pap smear, which only suggests the presence of an abnormality, colposcopy with biopsy provides a definitive diagnosis of dysplasia (a pre-cancerous change of the cervix), noting the extent of the abnormality. In this way, cervical abnormalities can be treated appropriately to avoid progression to cervical cancer.
The risks are minimal, and include a minimal amount of bleeding which is stopped by the routine use of chemical cauterizing agents. In addition, there is a very remote chance of developing an infection that would need to be treated with oral antibiotics.
The alternative to colposcopy would be either expectant management with follow-up Pap smears and a cervical culture that can identify certain types of the Human Papilloma Virus (HPV, or the virus known to cause genital warts) that may indicate the possibility of a more aggressive dysplastic cervical lesion. The last alternative is a much more aggressive surgical procedure called a LEEP / cone biopsy. For some changes in the cervix, follow-up Pap smears would be very appropriate.
Following the colposcopy, there should be minimal discomfort. Some mild cramping may be expected and relieved with Advil or other mild over-the-counter pain relievers. A discharge consisting of old blood and dried chemical cautery agent may be expected for several days following the colposcopic procedure. There should be no other unusual side effects. We will either call you with results or have you come back for a visit depending on your particular situation.