If you have had an abnormal Pap test or your cervix looks abnormal during a Gynecologic exam, your provider may recommend that you have a colposcopy. A colposcopy procedure uses an instrument similar to binoculars to look very closely at your cervix. If at the time of colposcopy the cervix does not look normal, your provider may perform a biopsy to remove a tiny sample of tissue. This sample will be sent to a laboratory to be evaluated by a pathologist to determine if more tests or treatments are needed. The entire colposcopy and biopsy procedure takes approximately 10 minutes. Most women experience only minor discomfort and they are able to resume their daily activities immediately following the visit.
Colposcopy is used to further evaluate abnormal cervical cancer screening tests or abnormal areas seen on the cervix, vagina, or vulva. The colposcope magnifies the appearance of the cervix, which allows your provider to see where the abnormal cells are located. The size and location of abnormal cells helps to determine what treatment, if any, is needed.
Before your colposcopy appointment, you should not put anything in the vagina and abstain from intercourse for 48 hours. Colposcopy can be done at any time during your menstrual cycle, but if you have heavy vaginal bleeding on the day of your appointment call to ask if you should reschedule.
Colposcopy can be performed by a physician or nurse practitioner who has had specialized training. Your healthcare provider will use an instrument called a speculum to open your vagina and look at your cervix. The colposcope is like a microscope on a stand, and it does not touch you. Your provider will apply a solution called acetic acid (vinegar) to your cervix, which helps to highlight any abnormal areas, making them easier to see. When this solution is used, you may feel a cold or slight burning sensation, but it does not hurt. During colposcopy, your healthcare provider may remove a small piece of abnormal tissue (a biopsy) from the cervix or vagina. Some women also need to have a biopsy of the inner cervix called endocervical curettage (ECC). The ECC may cause crampy pain, although this resolves quickly in most women. If you have a biopsy, your provider may apply a yellow-brown solution to your cervix, which helps to prevent bleeding.
The results of the biopsy may take two weeks to return. Once you have had an abnormal pap smear, even if your biopsy results are normal, it is important that you continue to have regular gynecologic exams. If the biopsy results are abnormal, you may require another minor procedure called LEEP (Loop electrosurgical excision procedure).