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Medical Author:

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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In this Article

• What is colposcopy?
• Why is colposcopy done?
• How is colposcopy done?
• What special tests are done during colposcopy?
• Acetic acid wash
• Use of color filters
• Biopsy of the cervix
• Based on the colposcopy results, what is the approach to treating cervical abnormalities?
• What should one expect from each of the treatments for cervical abnormalities?
• Carbon dioxide laser photoablation
• Cryocautery
• Loop electrosurgical excision procedure
• Cold knife cone biopsy
• Hysterectomy
• Colposcopy At A Glance
• Patient Comments: Colposcopy - Diagnosis
• Find a local Obstetrician-Gynecologist in your town
• Colposcopy Index

Loop electrosurgical excision procedure

Loop electrosurgical excision procedure, also known as LEEP, uses a radio-frequency current to remove abnormal areas. It has an advantage, therefore, over the destructive techniques (CO2 laser and cryocautery) in that an intact tissue sample for analysis can be obtained. LEEP also is popular because it is inexpensive and simple. A chemical is applied afterwards to prevent bleeding. Vaginal discharge and spotting commonly occur after this procedure. Sexual intercourse and tampon use should be avoided for several weeks to allow better healing.

Complications occur in about 1% to 2% of women undergoing LEEP, and include cervical narrowing (stenosis) and bleeding. This procedure is used most commonly for treating dysplasia, including severe dysplasia. LEEP also is used, although infrequently, to treat carefully chosen cases of cervical cancer.

Cold knife cone biopsy (conization)

Cone biopsy was once the major procedure used to treat cervical dysplasia, but the other methods have now replaced it for this purpose. However, when a physician cannot view the entire area that needs to be seen during colposcopy, a cone biopsy continues to be recommended. It is also recommended if special sampling is needed to obtain more information regarding certain types of more advanced abnormalities. This technique allows the size and shape of the sampling to be tailored.

Complications of this procedure include postoperative bleeding in 5% of women and narrowing of the cervix. Cone biopsy has a slightly higher risk of cervical complications than the other treatments. This procedure is occasionally used to treat carefully chosen cases of cervical cancer.