Name of the Procedure:

Colposcopy of the cervix including upper/adjacent vagina with biopsy(s) of the cervix

Summary

A colposcopy is a procedure where a healthcare provider uses a special magnifying instrument called a colposcope to closely examine the cervix, upper, and adjacent vagina. During this procedure, if any areas of concern are identified, a biopsy (a small sample of tissue) may be taken from the cervix for further analysis.

Purpose

This procedure is typically performed to investigate abnormal results from a Pap smear, to check for precancerous or cancerous cells in the cervix, and to diagnose other potential issues in the cervical area. The goal is to detect and address any abnormalities early to prevent the possible development of cervical cancer.

Indications

• Abnormal Pap smear results
• Unexplained bleeding or discharge
• Suspicion of HPV (Human Papillomavirus) infection
• Visual lesions on the cervix noticed during a pelvic exam

Preparation

• Patients are usually advised to avoid vaginal intercourse, douching, or using vaginal medications or tampons 24-48 hours before the procedure.
• It is generally recommended not to schedule the procedure during menstruation.
• No fasting is typically required, but the patient might be asked to empty their bladder before the procedure.

Procedure Description

1. The patient lies on an examination table and places their feet in stirrups.
2. A speculum is inserted into the vagina to gently open it.
3. The colposcope, which remains outside the vagina, is positioned to magnify the view of the cervix and upper vagina.
4. The cervix is cleaned with a mild vinegar solution, which helps highlight abnormal areas.
5. If any suspicious areas are identified, small tissue samples (biopsies) are taken from the cervix.
6. The tissue samples are sent to a laboratory for histopathological analysis.

Duration

The procedure typically takes about 15-30 minutes.

Setting

A colposcopy is usually performed in a hospital, outpatient clinic, or gynecologist’s office.

Personnel

• Gynecologist or trained healthcare provider
• Nurse or medical assistant

Risks and Complications

• Discomfort or pain during the biopsy
• Light bleeding or spotting after the procedure
• Infection (rare)
• Delayed or heavy bleeding (very rare)

Benefits

• Early detection of precancerous or cancerous cells
• Accurate diagnosis of abnormalities in the cervix
• Informing future treatment plans

Recovery

• Patients may experience mild cramping and spotting for a few days.
• It is generally advised to avoid intercourse, tampon use, and douching for a few days post-procedure.
• Follow-up appointments may be required to discuss biopsy results and any further treatment.

Alternatives

• Repeat Pap smear or HPV testing
• Cryotherapy, LEEP (Loop Electrosurgical Excision Procedure), or other minor surgical procedures if abnormalities are detected
• Pros: Less invasive alternatives such as repeat Pap smear may miss early detection of abnormalities.
• Cons: More invasive alternatives like LEEP may require longer recovery and carry higher risk if performed unnecessarily.

Patient Experience

Patients might feel slight discomfort or pressure when the speculum is inserted and during the biopsy. Pain is generally minimal and managed with over-the-counter pain relievers if needed. Post-procedure, mild cramping and spotting are common but usually resolve within a few days.