Test Overview
Colposcopy is a way for your doctor to use a special
magnifying device to look at your
vulva,
vagina, and
cervix. If the doctor sees a problem, he or she can take a
small sample of tissue (biopsy) from the cervix or
from inside the opening of the cervix. The sample is
looked at under a microscope.
This test is most often done when the result of a
Pap test is abnormal. Most abnormal Pap tests are
caused by viral infections. Examples are
HPV infection and other types
of infection, such as those caused by bacteria, fungi (yeast), or protozoa
(Trichomonas). Natural cervical cell changes (atrophic vaginitis) linked to
menopause can also cause an abnormal Pap test. In some
cases, untreated cervical cell changes that cause abnormal Pap tests may
become precancerous or cancerous changes.
During the test, your doctor uses a lighted magnifying device
that looks like a pair of binoculars. This device is called a colposcope. It allows your
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.
Your doctor may put vinegar (acetic acid) and sometimes iodine
on the vagina and cervix with a cotton swab or cotton balls. It allows the doctor
to see problem areas more clearly.
Why It Is Done
Colposcopy is done to:
- Look at the cervix for problem areas when a Pap
test was abnormal. If an area of abnormal tissue is found, a biopsy is often done.
- Check a sore or other problem (such as
genital warts) found on or around the vagina and
cervix.
- Follow up on abnormal areas seen on a previous colposcopy.
It can also be done to see if treatment for a problem
worked.
- Look at the cervix for problem areas if an HPV test shows a
high-risk type of HPV.
How To Prepare
Tell your doctor if you:
- Are or might be pregnant. A blood or urine test
may be done before the test to see if you are pregnant. Colposcopy
is safe during pregnancy. If a cervical biopsy is needed during the test,
the chance of any harm to the pregnancy (such as
miscarriage) is very small. But you may have more
bleeding from the biopsy. A colposcopy may be repeated about 6 weeks after
your baby is born.
- Take any medicines.
- Are allergic to
any medicines.
- Take a blood thinner, or if you have had bleeding problems.
- Have been treated for a vaginal,
cervical, or pelvic infection.
Do not have sex or put anything into your vagina for 24 hours before the test. This includes douches, tampons, and vaginal medicines. You will empty your bladder just before the test.
You may want to take a pain reliever, such as ibuprofen (Advil or Motrin). It is best to take it 30 to 60 minutes before the test, especially if a biopsy
may be done. This can help decrease any cramping pain that you may have.
Schedule your colposcopy for when you are not having your period. Heavy bleeding makes it harder for your doctor to see your cervix. The best
time to have this test is during the early part of your
menstrual cycle. This is usually 8 to 12 days after the start of your
last menstrual period.
You will be asked to sign a consent form that says you understand the risks of the test and agree to have it done.
Talk to your doctor
about any concerns you have regarding the need for the test. Ask about its risks,
how it will be done, or what the results will mean. To help you understand the
importance of this test, fill out the
medical test information form(What is a PDF document?).
How It Is Done
Colposcopy is usually done by a
gynecologist, a
family medicine physician, or a nurse practitioner who has been trained to do the
test. If a biopsy is done, the sample will be looked at by a
pathologist. This test can be done in your doctor's
office.
You will need to take off your clothes below the waist. You will be
given a covering to drape around your waist. You will then lie on your back on
an exam table. Your feet will be raised and put in foot rests
(stirrups).
The doctor will insert a lubricated tool called a speculum into your vagina. It gently spreads apart the vaginal
walls so your doctor can see inside the vagina and the cervix.
The colposcope is moved near your vagina. Your doctor looks
through it at the vagina and cervix. Vinegar (acetic acid) or
iodine may be used on your cervix to make abnormal areas
easier to see. Photos or videos of the vagina and cervix may be
taken.
If areas of abnormal tissue are found on the cervix, your doctor
will take a small sample of the tissue. This is called a cervical biopsy. Usually
several samples are taken. The samples are looked at under a microscope for
changes in the cells that may mean cancer may be present or is likely to
develop. If bleeding occurs, a special liquid (Monsel's) or silver nitrate swab
may be used on the area to stop the bleeding.
If a sample of tissue is needed from inside the opening of the
cervix, a test called endocervical curettage (ECC)
will be done. This area can't be seen by the colposcope. So a
small sharp-edged tool called a curette is gently put into the area to take a sample. ECC takes less than a minute to do. It may cause mild
cramping. An ECC is not done during pregnancy.
Colposcopy and a cervical biopsy usually take about 15
minutes.
How It Feels
You may feel some discomfort when the speculum is put in.
You may feel a pinch and have some cramping if a tissue sample is taken.
Risks
In rare cases, a cervical biopsy can cause an infection or
bleeding. Bleeding can usually be stopped by using a special liquid or swab on
the area.
After the test
If you have a biopsy, your vagina may feel sore for a day or two. Some
vaginal bleeding or discharge is normal for up to a week after the biopsy. The
discharge may be dark-colored. You can use a
sanitary pad for the bleeding. Do not douche, have sex, or use tampons for 1
week. This will allow time for your cervix to heal. Do not exercise for 1 day after
your colposcopy.
Follow any instructions your doctor gave you. Call your doctor if
you have:
- Heavy vaginal bleeding. (This means more than a normal
menstrual period).
- A fever.
- Belly
pain.
- Bad-smelling vaginal discharge.
Results
Colposcopy is a way for your doctor to use a special magnifying
device to look at your
vulva,
vagina, and
cervix.
Your doctor will talk to you about what he or she sees at the time
of the test. Lab results from a
biopsy may take several days or more.
Colposcopy and cervical biopsy| Normal: | The vinegar or iodine does not show any areas of abnormal
tissue. The vagina and cervix look normal. |
|---|
A biopsy sample does not show any abnormal
cells. |
|
Abnormal: | The vinegar or iodine shows areas of abnormal tissue. Sores
or other problems, such as
genital warts or an infection, are found in or around
the vagina or cervix. |
|---|
A biopsy sample shows abnormal cells. This may mean
cervical cancer is present or likely to develop. |
What Affects the Test
You may not be able to have the test, or the results may not be helpful, if:
- You have sex up to 24 hours before the test.
- You use douches, tampons, or vaginal creams
or medicines up to 24 hours before the test.
- You are having a
menstrual period at the time of the test.
- You have a vaginal or
cervical infection.
- You have gone through
menopause. Hormonal changes may make it hard to
see the cervical canal clearly.
What To Think About
- Colposcopy is not usually used as a screening
test for women at high risk for cervical cancer. A Pap test is done for that
purpose. But a colposcopy gives you and your doctor more information if you have an abnormal result from a Pap test.
- If a colposcopy and cervical biopsy are
normal, it is not likely that you have cell changes that can lead to cervical
cancer. But your doctor may still want you to have Pap tests more often for a period of time.
- Another biopsy may be needed if a Pap test, colposcopy, and
cervical biopsy show different results.
- Women with
HIV have a higher
chance of getting cervical cancer. A colposcopy is usually advised for women
with HIV and an abnormal Pap test.
References
Other Works Consulted
- Chernecky CC, Berger BJ (2008). Laboratory Tests and Diagnostic Procedures, 5th ed. St. Louis: Saunders.
- Fischbach FT, Dunning MB III, eds. (2009). Manual of Laboratory and Diagnostic Tests, 8th ed. Philadelphia: Lippincott Williams and Wilkins.
- Pagana KD, Pagana TJ (2010). Mosby's Manual of Diagnostic and Laboratory Tests, 4th ed. St. Louis: Mosby.
Credits
ByHealthwise Staff
Primary Medical ReviewerSarah Marshall, MD - Family Medicine
Martin J. Gabica, MD - Family Medicine
E. Gregory Thompson, MD - Internal Medicine
Kathleen Romito, MD - Family Medicine
Specialist Medical ReviewerKevin C. Kiley, MD - Obstetrics and Gynecology