What is a colposcopy?
Colposcopy is part of the gynecological examination. During this procedure, the doctor looks at the vagina and cervix with a colposcope – a medical instrument that works like a magnifying glass: Its six- to 40-fold magnification makes it possible to see tissue changes under illumination that are difficult to assess with the naked eye.
During the examination, the doctor can dab the cervix with special solutions. This stains certain cells, which allows conclusions to be drawn about any malignant cell changes (cancer or precancerous lesions) – colposcopy is an important tool in the early detection of cervical cancer.
When do you have a colposcopy?
Gynecologists perform colposcopy as a standard part of gynecological screening. In addition, the examination is used in the diagnosis of diseases or abnormalities of the cervix and vagina. These include:
- Suspicion of cancer
- suspicion of precancerous lesions
- suspicious cytological smears, e.g. PAP smear
- Cancer follow-up
- proven infections
- changes in the cervix
- bleeding of no known origin
- persistent discharge from the vagina
- inflammations
If tumors are suspected, a tissue sample may be taken as part of a biopsy during colposcopy.
Colposcopy is an outpatient procedure – women can go home afterwards.
One day before the colposcopy, they should refrain from using tampons and having sexual intercourse. The examination should also not coincide with menstruation.
The doctor will first take the patient’s medical history, including possible complaints and any previous illnesses.
For the colposcopy, the patient sits in a gynecological chair. The doctor dilates the vagina with an examination instrument, positions the colposcope in front of it – it is not inserted – and focuses it. He or she then inspects the mucosa of the cervix, paying particular attention to surface irregularities and abnormalities of the vessels.
Injuries or changes in the tissue can be visualized with the help of special solutions. This is done with the acetic acid test and Schiller’s iodine test.
Acetic acid test
The doctor dabs the mucous membrane with a three to five percent solution of acetic acid, which can cause a slight burning sensation. Healthy tissue does not change, while altered cells turn a whitish color. This finding is also called “acetic white”.
Schiller’s iodine test
For dilated colposcopy, an iodine solution is dabbed on. Healthy mucosa turns brown, i.e. it is iodine positive. Altered mucosa, on the other hand, does not change color or only changes color slightly.
Finally, the vagina and the external genitalia are examined. If there are any abnormalities, the doctor will take a tissue sample with a small forceps for fine tissue examination in a laboratory. Since the uterus is almost insensitive to pain, the sample is usually taken without anesthesia.
What are the risks of colposcopy?
Colposcopy is a safe examination without complications. Possibly the acetic acid causes a slight burning sensation. In rare cases, bleeding may occur due to the removal of the tissue sample. Very rarely, infections occur. If you suffer from iodine intolerance or hyperthyroidism, you must inform your doctor before the colposcopy. Colposcopy does not pose any risk to the child in case of pregnancy.
