Colposcopy
Medical Author: Melissa Conrad Stoppler
Medical Editor: William C. Shiel, Jr., MD, FACP, FACR
What is colposcopy?
Colposcopy is a gynecological procedure that illuminates and magnifies the vulva, vaginal walls, and uterine cervix in order to detect and examine abnormalities of these structures. The cervix is the base of the womb (uterus) and leads out to the birth canal (vagina).
During colposcopy, special tests [acetic acid wash, use of color filters, and sampling (biopsy) of tissues] can be done. Colposcopy is not to be confused with culdoscopy, which is the insertion of an instrument through the wall of the vagina in order to view the pelvic area behind the vagina.
Why is colposcopy done?
Colposcopy is usually done in one of two circumstances: to examine the cervix either when the result of a Pap smear is abnormal, or when the cervix looks abnormal during the collection of a Pap smear. Even if a Pap smear result is normal, colposcopy is ordered when the cervix appears visibly abnormal to the clinician performing the Pap smear. The purpose of the colposcopy is to determine what is causing the abnormal looking cervix or the abnormal Pap smear so that appropriate treatment can be given.
How is colposcopy done?
A colposcope is a microscope that resembles a pair of binoculars. The instrument has a range of magnification lenses. It also has color filters that allow the physician to detect tiny abnormal blood vessels on the cervix. The colposcope is used to examine the vaginal walls and cervix through the vaginal opening.
- The first step of the procedure is examining the vulva and vagina for signs of genital warts or other growths. (Genital warts are caused by the human papilloma virus
(HPV), which is a sexually transmitted virus that causes
cervical cancer.)
- A Pap smear is then taken.
- The cervix is inspected and the special tests are done (see below).
Colposcopy is a safe procedure with no complications other than vaginal spotting of blood.
The examiner wants to get a good look at the squamocolumnar junction, which is the area of the cervix that gives rise to most cases of cervical cancer. The term squamocolumnar junction refers to the border between the two different types of cells (squamous cells and columnar cells) that normally form the lining of the endocervical canal. (This canal connects the cervix with the main part of the uterus.) Most cases of cervical cancer originate from the squamous cells and, therefore, are referred to as squamous cell cervical cancer.
During colposcopy, the entire squamocolumnar junction is more likely to be
seen in young women. The reason for this is that after menopause, the squamocolumnar
junction tends to migrate inside the endocervical canal. Colposcopy, therefore,
is often not adequate in women after menopause. Therefore, if the whole
squamocolumnar junction area of the cervix is not visible on colposcopy, another
type of procedure may need to be performed that allows the entire squamocolumnar
junction to be examined. (See cold knife cone
biopsy below.)
Next: What special tests are done during colposcopy? »
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