What is a colposcopy?

A colposcopy is a diagnostic procedure that allows doctors a better look into the gynaecological organs, specifically the cervix and the vaginal canal. In this article, a consultant obstetrician and gynaecologist explains when colposcopies are recommended, and what to expect during the procedure.

What is the purpose of colposcopy?

A colposcopy is primarily used to check for abnormal cells in the cervix, which could possibly morph into conditions of concern like cancer, genital warts, or polyps. Colposcopies can also be used to investigate the causes of irregular bleeding or itchiness.

Patients may be recommended to undergo a colposcopy if they have had unusual results from a pelvic examination or a Pap smear, or have received a positive HPV test.

Colposcopies are performed by a gynaecologist or a colposcopist.

What happens during a colposcopy?

To prepare for a colposcopy, patients should avoid scheduling their appointment during their menstrual period, and they are recommended to abstain from vaginal penetration for at least two days before the procedure. Patients may feel more comfortable by taking a painkiller before their appointment.

Overall, the procedure typically takes 20 or so minutes. The patient lays on their back with their feet in the support stirrups while a speculum is inserted into the vaginal opening so that the doctor can access the vaginal canal.

What enables the doctor to get an in-depth look at the cervix and vaginal walls is the colposcope, a special magnifying tool that is placed a moderate distance away from the vulva with a bright light at the end. Excess mucus may be swabbed away to ensure a clear perspective, and a chemical solution may be applied to point out suspicious cells (this solution can sting). Using the colposcope, the doctor can examine any areas of note, and can perform a biopsy during this by extracting samples of tissue to be analysed in a laboratory at a later time.

After the colposcopy, the patient may experience light spotting or bleeding for a couple of days, especially if a biopsy was conducted. This is normal, as the cervix will need a bit of time to heal. In the interim, patients are advised to further avoid vaginal penetration and to use menstrual pads or liners for their comfort.

What happens after a colposcopy?

If the laboratory results show that there are abnormal or precancerous cells in the cervix. This can be done with a large loop excision of the transformation zone (LLETZ) procedure, which can be performed on the same colposcopy.

A local anaesthetic is injected into the cervix to prevent pain sensation, and then a heated coil of wire is used to excise the area of abnormal tissue, at most the size of a fingernail’s worth. Overall, this is also a short procedure, taking around 15 minutes.

If a larger area of tissue needs to be removed, a cone biopsy is an alternative to LLETZ. This is a more intensive procedure which requires the patient to be under a general anaesthetic to remove a cone-shaped area of cervical tissue, so it typically cannot be performed the same day as the colposcopy and the patient will need to schedule a new appointment for this. 

If you would like to know more about colposcopy, consult with a specialist on Top Doctors today.