“Hi! We need to you come in for some tests.”
No women wants to get that call from your OBGYN, However it
is not always as scary as you might think. It you do get a call from your
doctor after your pap smear and they suggest a Colposcopy don’t be afraid.
What is a Colposcopy?
A colposcopy is a test where you
OBGYN uses a special
magnifying glass and light, a colposcope, to look directly at the vulva, vagina
and cervix. This allows the doctor to see cellular changes which may be causing
the pap smear test to come back abnormal.
Many abnormal Pap tests are caused by viral infections, such
as HPV infection, or other types of infection like bacteria, fungi (yeast), or
protozoa (Trichomonas). Abnormal pap test can also be the result of natural
cervical cell changes (atrophic vaginitis) related to menopause. In some cases,
untreated cervical cell changes that cause abnormal Pap tests may progress to
precancerous or cancerous changes. The colposcopy will help determine if you
need treatment and if so what kind of treatment will be most affective.
How is it done?
Step One: Pre-Colposcopy instructions. You will be told by the doctor or nurse that
for the few days before the exam to avoid vaginal intercourse. This is because
seamen which stay in the body for up to 72 hours can interfere with the
doctor’s ability to visualize the cervical cells. Also, if you start your period
right before you are supposed to have a colposcopy it is important to call you
doctor and reschedule. Menstrual bleeding will also have the same effect.
Step Two: The appointment. The day of your appointment you will
sign in and get ready in the exam room just like you are having another pap
smear. You will disrobe from the waist down and put on a drape.
Once you have your feet in the stirrups and are in position
the doctor will insert a speculum – the curved instrument that holds the
vaginal walls apart so that they doctor can see you cervix.
This is exactly the same as a regular pelvic
exam. Then the
doctor will use a vinegar
(acetic acid) or iodine (Lugol’s Solution) to make any areas of abnormal cells
more visible to the eye and for the camera if the doctor has attached the
camera to the colposcope.
Step Three: Abnormal Cell Biopsy. In some cases the doctor will
look through the colposcope and see that there is really no problem. This means
that the abnormality on the pap smear was not serious but they may recommend
that you have your pap smears at more frequent intervals like every 6 months
rather then a year. This will be determined by you doctor based on what is seen
and your medical history.
However, if visible abnormalities look significant then your
doctor may take small tissue samples directly from the abnormal areas they see.
This is called a Biopsy. This can pinch and cause some discomfort – but it is
important for proper diagnosis. If a biopsy is done there may be a little
bleeding. A special solution (Monsel’s Liquid) or a nitrate swab may be used to
stop the bleeding. If a sample is needed from inside the cervical opening then
an endocervical curette will be used to take a sample of tissue from this area.
Again this may cause cramping or discomfort – but it only lasts a minute.
Usually this procedure lasts about 15 minutes.
After the colposcopy you will probably feel fine. However if
you had a biopsy, you may have some vaginal soreness for a day or two. A little
bleeding or discharge is normal for up to a week after a biopsy. It also may be
dark in color because of the solutions used during the biopsy. Use a sanitary
pads for the bleeding. Do not douche, have sex, or use tampons for one week, to
allow time for your cervix to heal and avoid exercise for one day after your
colposcopy.
Follow any extra instructions your doctor gives you and Call your doctor if you have:
Heavy vaginal bleeding (more than a normal menstrual
period).
A fever.
Belly pain.
Bad-smelling vaginal discharge.
Although colposcopy and cervical biopsy are very safe, there
are always small risks of infection or bleeding so be aware of how you feel and
any symptoms.
The Results – In the best case the doctor will not see any
areas of abnormal cells during you test and you will not have to receive
treatment.
The abnormalities seen during the test sores, genital warts
or an infection, may be found in or around the vagina or cervix. If this is the
case your doctor may prescribe medicine for you or other course of treatment.
If precancerous or cancerous cells are detected then
you may need further procedures to remove these cells so that they do not
spread causing more serious health issues.