Colposcopy is a painless examination of the uterine cervix and the vagina in order to detect lesions not visible with naked eye.
It is crucial that colposcopy is performed by specialized doctors. Dr. Tsoumpou is certified by the British Society of Colposcopy and Cervical Pathology (BSCCP) as well as by the Hellenic Society of Colposcopy and Cervical Pathology (HSCCP).
Indications
- Abnormal Pap-test or liquid based cytology
- Detection of High Risk HPV (HR-HPV)
- Follow-up of women after treatment (Loop- LLETZ- cervical diathermy)
- In case of lesions in cervix and vagina, detected during gynaecological examination
Differences between Papanicolaou test and colposcopy
In a Papanicolaou test we collect a random specimen of cells from the cervical surface and the endocervical canal. In case of atypical cells found during examination of that specimen under the microscope, it is impossible to know the exact location of their origin.
Colposcopy indicates a specific area of the cervix showing a lesion, out of which a biopsy is obtained. The biopsy allows for a diagnosis, provided that it is obtained by the right area. This is why we resort to colposcopy. Doctors performing the colposcopy need to be specialized. If this is not the case, they might obtain a biopsy from a wrong area and the results may be misleading.
How is colposcopy conducted?
Colposcopy may be conducted in every phase of the menstrual cycle unless there is heavy vaginal bleeding and therefore it has to be postponed.
The initial stages of the examination are similar to the Papanicolaou test examination. The difference is that since we insert the vaginal speculum and observe the cervix, we use a special instrument, the colposcope which is a type of microscope.
Colposcopy is a painless examination that lasts about 5-10 minutes. The colposcope is not inserted into the vagina. It contains a magnifying glass which allows us to examine the cervix in greater detail. Afterwards, we apply a special liquid on the cervix. The liquid is left to be absorbed for 30 seconds. This will help detecting pathological areas in the cervix with possible abnormal cells, which appear to be white.
If needed, we can obtain in the clinic a small punch biopsy from the cervix.
Taking a cervical biopsy does not necessarily mean that there are pre-cancerous cells but helps certifying through the tissue examination the exact type of the abnormality. The tissue specimen is sent to a special laboratory to be examined.
What does colposcopy show?
Colposcopy shows the location, type and extent of a cervical lesion thus helping us decide if-and- what type of treatment is needed.
The results of a biopsy taken under colposcopic examination might be normal or be referred as cervical intraepithelial neoplasia (CIN).
There are 3 different types of CIN depending on the number of abnormal cells:
- CIN 1 means that only 1/3 of the cells are abnormal
- CIN2 means that up to 2/3 of the cells are abnormal
- CIN3 means that all cells are abnormal
Usually, CIN2 and CIN3 require treatment that will be discussed with the doctor.
After colposcopy
The majority of women are able to return to work and everyday routine right after the colposcopic examination. In some cases, they might suffer mild pain or cramps that recede within 1-2 hours. In rare cases, simple painkillers will be needed such as paracetamol.
If a biopsy is taken, we suggest that the woman refrains from sexual activity and from use of tampon or vaginal creams for 48 hours.
The results of the biopsy will be available within 7-14 days. The possible additional examinations and treatment will be based on these results. Women who have abnormal cells need more frequent check-up or immediate treatment, depending on the grade of lesion.
Colposcopy during pregnancy
Colposcopy is a safe examination to be conducted during pregnancy and is suggested when there is a pathological Papanicolaou test. However, it should be carried out only by an experienced colposcopist who can distinguish the normal changes of the cervix during pregnancy that mimes a pathological cervix, from the actual pathological changes.
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