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Colposcopy

Has your doctor has recommended a scary-sounding procedure called colposcopy?!
What is a colposcopy and how and why is it performed?
Colposcopy is an office procedure in which the cells on the surface of the cervix can be visualized under magnification. The most common reason for performing a colposcopy is to evaluate the cervix after an abnormal Pap smear. Keep in mind that Pap smears are good screening tests, while colposcopy is a diagnostic test.
A Pap smear is done by gently scraping the cervix and obtaining some cells from the surface. These cells are then analyzed microscopically in a laboratory in order to check for cancer cells. Sometimes the cells are determined to be abnormal, or atypical. While atypical cells are not cancerous cells, they do usually warrant further evaluation by colposcopy.
By using colposcopy to magnify the view of the cervix, I can look for areas of abnormalities and take samples, or biopsies, of those abnormalities. The tissue removed by biopsy is also analyzed microscopically and this result provides the actual diagnosis. Because the colposcopy-directed biopsies contain millions of cells, not just the few hundred thousand cells on a Pap smear, they provide much more information about the health of your cervix.
Now, the bad news about the procedure is that it can be very uncomfortable. I perform the procedure in a regular exam room and the patient assumes the usual Pap smear position on the table. The speculum is placed and this feels just like a regular Pap smear. I then view the cervix through an instrument that looks like binoculars on a stand. This instrument does not touch the patient; I just use it to magnify the view of the cervix. Next I gently apply a mild vinegar solution. Amazingly, the mild vinegar solution works by drying, or dehydrating, the surface a little and this changes the appearance of any microscopically abnormal cells. Next I remove small biopsies from the cervix. These biopsies are usually about 1/16th to 1/8th of an inch in size and feel like pinches. Sometimes this can also lead to a menstrual-cramp feeling or a mild burning. These discomforts usually pass quickly. Then I apply a solution to each biopsy site to make a small scab form and then the procedure is over. The entire procedure takes 5 to 15 minutes. I usually recommend no intercourse or tampons for 5 days after colposcopy.
Before the colposcopy procedure, I often recommend that my patients take a small dose of ibuprofen, provided they do not have any contraindication to this medicine. Check with your own doctor to see if this is allowed. As usual, the information in this blog does not serve to provide any specific individual medical advice and does not indicate any doctor-patient relationship.

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