Colposcopy

What is a colposcopy?

A colposcopy is a procedure that allows a health care provider to closely examine a woman's cervix, vagina, and vulva. It uses a lighted, magnifying device called a colposcope. The device is placed at the opening of the vagina. It magnifies the normal view, allowing your provider to see problems that can't be seen by the eyes alone.

If your provider sees a problem, he or she may take a sample of tissue for testing (biopsy). The sample is most often taken from the cervix. This procedure is known as a cervical biopsy. Biopsies may also be taken from the vagina or vulva. A cervical, vaginal, or vulvar biopsy can show if you have cells that are at risk for becoming cancer. These are called precancerous cells. Finding and treating precancerous cells may prevent cancer from forming.

Other names: colposcopy with directed biopsy

What is it used for?

A colposcopy is most often used to find abnormal cells in the cervix, vagina, or vulva. It may also be used to:

• Check for genital warts, which may be a sign of an HPV (human papillomavirus) infection. Having HPV may put you at higher risk for developing cervical, vaginal, or vulvar cancer.
• Look for noncancerous growths called polyps
• Check for irritation or inflammation of the cervix

If you've already been diagnosed and treated for HPV, the test may be used to monitor cell changes in the cervix. Sometimes abnormal cells return after treatment.

Why do I need a colposcopy?

You may need this test if you had abnormal results on your Pap smear. A Pap smear is a test that involves getting a sample of cells from the cervix. It can show if there are abnormal cells, but it can't provide a diagnosis. A colposcopy provides a more detailed look at the cells, which may help your provider confirm a diagnosis and/or find other potential problems.

You may also need this test if:

• You have been diagnosed with HPV
• Your provider sees abnormal areas on your cervix during a routine pelvic exam
• You have bleeding after sex

What happens during a colposcopy?

A colposcopy may be done by your primary care provider or by a gynecologist, a doctor who specializes in diagnosing and treating diseases of the female reproductive system. The test is usually done in the provider's office. If abnormal tissue is found, you may also get a biopsy.

During a colposcopy:

• You will remove your clothing and put on a hospital gown.
• You will lie on your back on an exam table with your feet in stirrups.
• Your provider will insert a tool called a speculum into your vagina. It is used to spread open your vaginal walls.
• Your provider will gently swab your cervix and vagina with a vinegar or iodine solution. This makes abnormal tissues easier to see.
• Your provider will place the colposcope near your vagina. But the device will not touch your body.
• Your provider will look through the colposcope, which provides a magnified view of the cervix, vagina, and vulva. If any areas of tissue look abnormal, your provider may perform a cervical, vaginal, or vulvar biopsy.

During a biopsy:

• A vaginal biopsy can be painful, so your provider may first give you a medicine to numb the area.
• Once the area is numb, your provider will use a small tool to remove a sample of tissue for testing. Sometimes many samples are taken.
• Your provider may also do a procedure called an endocervical curettage (ECC) to take a sample from the inside of the opening of the cervix. This area can't be seen during a colposcopy. An ECC is done with a special tool called a curette. You may feel a slight pinch or cramp as the tissue is removed.
• Your provider may apply a topical medicine to the biopsy site to treat any bleeding you may have.

After a biopsy, you should not douche, use tampons, or have sex for a week after your procedure, or for as long as your health care provider advises.

Will I need to do anything to prepare for the test?

Do not douche, use tampons or vaginal medicines, or have sex for at least 24 hours before the test. Also, it's best to schedule your colposcopy when you are not having your menstrual period. And be sure to tell your provider if you are pregnant or think you may be pregnant. Colposcopy is generally safe during pregnancy, but if a biopsy is needed, it can cause extra bleeding.

Are there any risks to the test?

There is very little risk to having a colposcopy. You may have some discomfort when the speculum is inserted into the vagina, and the vinegar or iodine solution may sting.

A biopsy is also a safe procedure. You may feel a pinch when the tissue sample is taken. After the procedure, your vagina may be sore for a day or two. You may have some cramping and slight bleeding. It's normal to have a little bleeding and discharge for up to a week after the biopsy.

Serious complications from a biopsy are rare, but call your provider if you have any of the following symptoms:

• Heavy bleeding
• Abdominal pain
• Signs of infection, such as fever, chills and/or bad smelling vaginal discharge

What do the results mean?

During your colposcopy, your provider may find one or more of the following conditions:

• Genital warts
• Polyps
• Swelling or irritation of the cervix
• Abnormal tissue

If your provider also performed a biopsy, your results may show you have:

• Precancerous cells in the cervix, vagina, or vulva
• An HPV infection
• Cancer of the cervix, vagina, or vulva

If your biopsy results were normal, it's unlikely that you have cells in your cervix, vagina, or vulva that are at risk for turning into cancer. But that can change. So your provider may want to monitor you for cell changes with more frequent Pap smears and/or additional colposcopies.

If you have questions about your results, talk to your health care provider.

Is there anything else I need to know about a colposcopy?

If your results showed you have precancerous cells, your provider may schedule another procedure to remove them. This may prevent cancer from developing. If cancer was found, you may be referred to a gynecologic oncologist, a provider who specializes in treating cancers of the female reproductive system.