Colposcopy of the Vagina and Cervix

What is colposcopy?

During the exam your provider may take a sample of tissue (biopsy) for lab tests.

When is it used?

Colposcopy is most often done if you have had an abnormal Pap test result showing:

• possible infection
• precancerous cells
• cells that look like cancer
• any other abnormal cells.

This exam may be done as part of a pelvic exam if your provider wants to get a closer look at an area of your vulva, vagina or cervix. It may also be done if you have had more than 1 test showing human papilloma virus (HPV) infection.

Tell your provider if you think you may be pregnant. Colposcopy can be done during pregnancy. However, your provider may wait to do a biopsy until after your baby is born.

How do I prepare for a colposcopy?

• Plan to have the exam when you are not having a menstrual period. These exams are usually not done during your period.
• Do not douche, have sexual intercourse, or use any medicines in the vagina for at least 24 hours before the exam.
• Follow any other instructions your healthcare provider gives you.

What happens during the procedure?

Because the cervix feels little pain, you will not need an anesthetic.

You will lie on your back on the exam table with your knees bent and the heels of your feet in stirrup heel holders, just as you do for a regular pelvic exam. Your provider will put a speculum into your vagina. This is the same tool used during a Pap test. Your provider will open it slightly so the cervix can be seen. Your provider will use a swab to put a weak vinegar solution on your vulva, vagina, or cervix. You may feel a slight stinging from the liquid.

Your provider will put the colposcope at the opening of your vagina. When your provider looks through the colposcope into the vagina, he or she will be able to see your cervix as well as the vagina. The vinegar solution turns abnormal tissue white and shows abnormal blood vessels. It helps show where samples of tissue should be taken for a biopsy. Photographs may be taken. Your provider may use a tool to remove 1 or more small pieces of tissue for lab tests. The tissue is usually the size of a pinhead. You may feel a pinch or slight cramp. After the tissue is removed, your provider may put a thick, pasty solution on the area of the biopsy. This will help prevent bleeding.

Your provider may also take a small scraping from the inner canal of the cervix.

Tissue that was removed will be sent to the lab for tests.

What happens after the procedure?

Your healthcare provider will tell you what he or she saw. Test results should be ready in 1 to 2 weeks.

A few women feel a little lightheaded right after the exam and need to lie down for a few minutes after the exam is over. You may have some cramping for a short time.

You may have a little dark-colored, sandy discharge from the vagina for a few days after the procedure. If you had a biopsy, you may have light bleeding or spotting for up to a week. You may notice a thick black discharge after a biopsy, caused by the paste put on the biopsied area. When the paste mixes with blood, it forms a thick black discharge. This discharge may last for a few days.

If a biopsy was done, you should not douche or use tampons for 1 to 2 weeks while the area heals. Use a pad for any bleeding. Do not have sexual intercourse for 1 to 2 weeks after the biopsy. Your provider may ask you to avoid intercourse until you have had a chance to talk about the test results.

Ask your provider what other steps you should take and when you should come back for a checkup. If the results are normal, no treatment may be needed and your provider will tell you when to come back for your next Pap test or HPV test. However, if lab tests of the biopsy found abnormal cells, your provider may recommend a treatment for the type of problem that was found. This may involve the use of medicine, laser, or freezing treatments, or even surgery to remove the area of abnormal cells. Your provider should review all of your results and treatment options with you at your follow-up visit.

What are the benefits of this procedure?

Benefits of this procedure are:

• Your healthcare provider should be able to make a more accurate diagnosis of the problem in your vulva, vagina, or cervix and suggest further treatment if necessary.
• The procedure can be done while you are awake and without an anesthetic.
• The procedure can be done in your provider's office rather than a hospital.
• The procedure is simple with few side effects or complications.

What are the risks associated with this procedure?

Minor bleeding from the biopsy site is common. You may also have mild cramping. Other risks include:

• heavy bleeding (soaking more than one pad per hour, or more bleeding than your normal menstrual flow)
• infection

You should ask your healthcare provider how these risks might apply to you.

When should I call my healthcare provider?

Call your provider right away if:

• You have heavy bleeding.
• You have a fever over 100.5°F (38°C) 24 to 72 hours after the procedure.
• You have bleeding that lasts longer than 2 weeks.
• You have a vaginal odor or discharge that smells bad.
• You have pelvic pain.

Call during office hours if:

• You have questions about the exam or its result.
• You want to make another appointment.