• Piedmont Women's Healthcare

Colposcopy is a way for the doctor to use a special magnifying device to look at your vulva, vagina and cervix. If a problem is seen during colposcopy, a small sample of tissue (biopsy) may be taken from the cervix or from inside the opening of the cervix (endocervical canal). The sample is looked at under a microscope.

Colposcopy is usually performed to look at the vagina and cervix when a Pap test is abnormal. Many abnormal Pap tests are caused by viral infections or other types of infection. Natural cervical cell changes (atrophic vaginitis) related to menopause can also cause an abnormal Pap test. In some cases, untreated cervical cell changes that cause abnormal Pap tests may progress to precancerous or cancerous changes.

During colposcopy, the doctor uses a lighted magnifying device that looks like a pair of binoculars (colposcope). The colposcope allows the doctor to see problems that would be missed by the naked eye. A camera can be attached to the colposcope to take pictures or videos of the vagina and cervix.

Why it is performed
Colposcopy is performed to:

How to prepare
Tell your doctor if you:

• Are or might be pregnant. A blood or urine test may be performed before the colposcopy to see whether you are pregnant. Colposcopy is safe during pregnancy. If a cervical biopsy is needed during a colposcopy, the chance of any harm to the pregnancy (such as miscarriage) is very small. However, you may have more bleeding from the biopsy. A colposcopy may be repeated about six weeks after delivery.
• Are taking any medicines.
• Are allergic to any medicines.
• Have had bleeding problems or take blood thinners, such as aspirin or warfarin (Coumadin).
• Have been treated for a vaginal, cervical or pelvic infection.

Do not douche, use tampons or use vaginal medicines for 24 hours before a colposcopy. The bladder is emptied just before the colposcopy.

You may want to take a pain reliever, such as ibuprofen (Advil or Motrin), 30 to 60 minutes before having a colposcopy, especially if a biopsy is performed. This can help decrease any cramping pain that can be caused by the colposcopy.

A colposcopy is not usually performed during your menstrual period because blood cells make it harder for ther doctor to see your cervix.

The patient needs to sign a consent form that says you understand the risks of colposcopy and agree to have the colposcopy performed. Talk to the doctor about any concerns you have regarding the need for the colposcopy, its risks, how it is performed or what the results mean.

How it is performed
Colposcopy is usually performed by a gynecologist, a family medicine physician or a nurse practitioner who has been trained to do the test. If a biopsy is performed, the sample is looked at by a pathologist. Colposcopy can be performed in your doctor's office.

The patient needs to take off their clothes below the waist. The patient is given a covering to drape around their waist. The patient lies on their back on an examination table with their feet raised and supported by foot rests (stirrups).

The doctor puts an instrument with smooth, curved blades (speculum) into the vagina. The speculum gently spreads apart the vaginal walls so the doctor can see inside the vagina and the cervix.

The colposcope is moved near the vagina and the doctor looks through the microscope at the vagina and cervix. Photographs or videos of the vagina and cervix may be taken.

If areas of abnormal tissue are found on the cervix, the doctor takes a small sample (cervical biopsy) of the tissue. If bleeding occurs, a special liquid or silver nitrate swab may be used on the biopsy area to stop the bleeding.

Colposcopy and a cervical biopsy usually take about 15 minutes.

How it feels
The patient may feel some discomfort when the vaginal speculum is inserted. The patient may feel a pinch and have some cramping if a biopsy sample is taken.

After the test
The patient may feel some soreness in the vagina for a day or two. Some vaginal bleeding or discharge is normal for up to a week after a biopsy. A sanitary pad can be used 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 the doctor gave you. Contact the doctor if you have:

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