Colposcopy - Directed Biopsy
A colposcopy is a special way of looking at the cervix. It uses a light and a low-powered microscope to make the cervix appear much larger. This helps your health care provider find and then biopsy abnormal areas in your cervix.
How the Test is Performed
You will lie on a table and place your feet in stirrups, to position your pelvis for exam. The provider will place an instrument (called a speculum) into your vagina to see the cervix clearly.
The cervix and vagina are gently cleaned with a vinegar or iodine solution. This removes the mucus that covers the surface and highlights abnormal areas.
The provider will place the colposcope at the opening of the vagina and examine the area. Photographs may be taken. The colposcope does not touch you.
If any areas look abnormal, a small sample of the tissue will be removed using small biopsy tools. Many samples may be taken. Sometimes a tissue sample from inside the cervix is removed. This is called endocervical curettage (ECC).
How to Prepare for the Test
There is no special preparation. You may be more comfortable if you empty your bladder and bowel before the procedure.
Before the exam:
- Do not douche (this is never recommended).
- Do not place any products into the vagina.
- Do not have sex for 24 hours before the exam.
- This test should not be done during a heavy period, unless it is abnormal.
You may be able to take ibuprofen or acetaminophen (Tylenol) before the colposcopy. Ask your provider if this is OK, and when and how much you should take.
How the Test will Feel
You may have some discomfort when the speculum is placed inside the vagina. It may be more uncomfortable than a regular Pap test.
- Some women feel a slight sting from the cleansing solution.
- You may feel a pinch or cramp each time a tissue sample is taken.
- You may have some cramping or slight bleeding after the biopsy.
- Do not use tampons or put anything in the vagina for several days after a biopsy.
Some women may hold their breath during pelvic procedures because they expect pain. Slow, regular breathing will help you relax and relieve pain.
You may have some bleeding after the biopsy, for about 2 days.
- You should not douche, place tampons or creams into the vagina, or have sex for up to a week afterward.
- You can use sanitary pads.
Why the Test is Performed
Colposcopy is done to detect cervical cancer and changes that may lead to cervical cancer.
It is most often done when you have had an abnormal Pap smear or HPV test. It may also be recommended if you have bleeding after sexual intercourse.
Colposcopy may also be done when your provider sees abnormal areas on your cervix during a pelvic exam. These may include:
- Any abnormal growth on the cervix, or elsewhere in the vagina
- Genital warts or HPV
- Irritation or inflammation of the cervix (cervicitis)
The colposcopy may be used to keep track of HPV, and to look for abnormal changes that can come back after treatment.