Colposcopy

Last updated on November 29th, 2023 at 01:24 pm

Background

Colposcope was developed by a German scientist namely “Hans Hinselmann” in 1924 in Hamburg, Germany.

This has enabled physicians around the globe to detect any abnormalities in women’s cervical regions when they are relatively small.

But in the present context of the twenty-first century, it has been used throughout the globe as a follow-up procedure to aberrant PAP (Papanicolaou) test results where cell samples are collected for analysis.

But on the contrary, a colposcope gives the physician an added edge of viewing the cells in real-time, inside the body (cervix), with the aid of a device consisting of magnifying lenses, and a light source.

Introduction

Colposcopy is an alternative screening that has been used in the examination, and thereby the treatment of internal tissues, especially premalignant cervical lesions.

Colposcopy is considered the gold standard to detect the biopsies of squamous-intraepithelial lesions and cervical cancer.

The introduction of this technique has been a boon in treating cervical cancers, which has a mortality rate of 3,11,000 deaths annually, amongst which 91% of deaths occur in low and middle-income countries.

Colposcopy is a test designed to get a closer look at a woman’s vagina and cervical regions to examine any anatomical abnormalities therein or any signs of earlier stages of cervical cancer.

The cervix is the opening of a woman’s womb through their vagina. These are generally performed to screen any cervical changes caused by certain human papillomavirus (HPV), which if untreated might lead to cervical cancer.

Why is Colposcopy Done?

A colposcopy is done if a woman has abnormal cells in the PAP smear test which is done for cervical screening and this is caused by HPV.

Or when the PAP smear doesn’t give a clear result. It can also be done to find out the cause of abnormal bleeding like contact bleeding.

Moreover, it also facilitates women to identify,

Genital warts
Inflammation of the cervix (cervicitis)
Precancerous changes in the cervical tissues
Precancerous changes in the vaginal tissues

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How is a Colposcopy Done?

During the examination, physicians use a colposcope to illuminate and magnify a woman’s cervical tissues.

Firstly, during the procedure, the woman would lay on her back with open legs, while the colposcope is positioned directly in front of her vagina.

Next, the physician inserts a smooth tube called a speculum into the vagina, while a colposcope that stays outside is used to examine the inner lining of the tissues in greater detail.

Moreover, a small sample of cells known as a biopsy can be taken out from the cervix for further testing if required. The stepwise guide includes,

Your clothing will be removed and you need to wear a hospital gown.
You will have to sit on your back with your legs wide open and your feet in the stirrups.
Your provider will insert the speculum inside the vagina, which helps in opening up the vaginal wall and give a clear view of the cervix and vagina.
Diluted Acetic acid will be swabbed in your cervix and vagina and kept for some time to note any abnormalities. This is followed by the application of Lugol’s iodine.
Your physician will eventually take a closer, and more detailed look at your cervical regions, vagina, or vulva, to elucidate the nature of the problem.
While a biopsy can also be taken, if necessary.

Points to be noted before Colposcopy

There are certain things not to be done before the colposcopy test such as,

Should not have intercourse for 24 hours before colposcopy
Should not use any products like vaginal creams or medicines 24 hours prior to colposcopy

Moreover, you might feel very anxious about the test, which might result in nervousness, anxiety, and lack of sleep. So, it’s wise for you to cope with the situations appropriately, and here are a few things you can do to prepare for your screening:

Inquire your physician about the procedure and ask for the brochure, or pamphlets if possible.
Write your questions and queries about the technique and ask your doctor before your test.
And also inquire your doctor if you can listen to quiet music during your test.

Risks, and Complications involved during the procedure

Generally speaking, colposcopy is a safe procedure, but there might be chances of some minor complications if a cervical biopsy is taken. These complications are:

Heavy bleeding which is unusually higher than during your period
Unpleasant vaginal discharge associated with chills, and fever
Severe abdominal pain

Share with your doctor about the symptoms involved if you are having any one of them.

Who should do a Colposcopy?

Colposcopy is generally recommended for women, who are suspected to have abnormal cells in the cervix after a smear test.

In other words, if your cervical screening points to abnormal cervical cells especially associated with high-risk human papillomavirus (HPV), you might be invited for a colposcopy from your clinic for further examination.

It can, therefore, shed light on any other abnormalities in the inner epithelial lining and its causative agents such as vaginal bleeding.

Here is the list of reasons to have a colposcopy:

Abnormal results in your PAP smear test, which detects that you have abnormal cells.
If you have been diagnosed with (HPV) Human Papilloma Virus
If your physician sees an abnormal area on your cervix during a routine pelvic examination
Or if you have frequent bleeding after sex

Which doctor does Colposcopy?

Colposcopy is generally done by a gynecologist at their primary care provider or someone who specializes in diagnosing and treating the female reproductive system.

Your physician might start the conversation with general questions regarding your reproductive health, and then this might lead to the physical examination of your cervical region using a colposcope.

Finally, if there are any abnormalities detected, a biopsy of the samples might be taken for further examination.

What happens during Biopsy?

During a biopsy, small samples of tissues are taken out from the suspected areas of abnormal tissues, using some biopsy forceps.

These tissue samples or biopsy is usually further analyzed in the laboratory using various chemicals and stains to elucidate the nature of the problem.

Hence, your doctor might apply chemicals to the biopsy area to limit bleeding. After your biopsy, you might experience,

Vulvar or vaginal pain that lasts for a couple of days
Light bleeding from your vagina that might last for a couple of days
You may experience dark discharge from your vagina

Nevertheless, if your biopsy is not done, you won’t have any restrictions on activities after your test is over.

Further Management

If the doctor finds abnormal cells and a biopsy is taken, then further treatment depends on the result of the biopsy report.

Colposcopy at Clinic One

Cervical cancer can be cured if diagnosed at an early stage and treated promptly.

We have recently introduced colposcopy in Kathmandu Nepal at “Clinic One” on top of the PAP test.

If you or anyone you know have been experiencing any abnormalities in their reproductive (cervical) region, and/or have an abnormal (PAP) smear test, please call us at 01-5400400/ 9863393960 or mail us at info@clinicone.com.np to book an appointment.

Request an appointment with our Gynecologist>>>

Conclusion

In conclusion, you might want to get a colposcopy test done if you are experiencing any kind of abnormalities in your cervical region.

Since these tests can prevent your abnormality to develop into cervical cancer. But you might want to start with a PAP test before you conclude doing a colposcopy test.

Please make sure that you ask your doctor when you shall receive the results, and for a phone number to contact if in case of any abnormalities involved such as excessive bleeding at home.


References

Lyufang Duan (2020) Thermocoagulation versus cryotherapy for the treatment of cervical precancers, The journal of “Obstetrics and Gynaecology Research”.

Marlieke de Fouw et. al. (2019) A systematic review and meta-analysis of thermal coagulation compared with cryotherapy to treat precancerous cervical lesions in low and middle-income countries, The International Journal of Gynecology and Obstetrics.

Medicine Plus, Colposcopy, National Library of Medicine

NHS (National Health Service) (2022) What is colposcopy?

Patsy Ciardullo (2017) Colposcope and Colposcopy (1925-1980), The Embryo Project Encyclopedia

WHO (2019) WHO guidelines for the use of thermal ablation for cervical pre-cancer lesions.