What is a Colposcopy and Why Would I Need One?

Cervical cancer screening is an important part of staying healthy. If your Pap smear results are abnormal, the next step is for you to have a colposcopy. This procedure is performed by your doctor using a type of instrument that magnifies the area of concern on your cervix or vulva. The procedure takes approximately 10 - 15 minutes and is done in our office. It is generally considered painless unless other procedures such as a tissue sampling or biopsy are done. Any samples taken are sent to a pathology laboratory for evaluation. The colposcopy will determine if further tests or treatment is needed.

Preparing for a Colposcopy

Schedule your colposcopy procedure for when you will not be on your period. We recommend that you take an over the counter pain reliever such as ibuprofen (Advil), or acetaminophen (Tylenol), 30 to 60 minutes prior to the procedure. Do not douche, use tampons, put medications in your vagina, or have vaginal intercourse for at least 24 hours before the procedure. If you are pregnant or if you take any blood-thinning medications like aspirin or Coumadin, it is important to let your health care provider know.

Procedure Description

Having a colposcopy is similar to getting a pap smear. You will need to position yourself at the end of the exam table. A speculum is placed inside your vagina in order to visualize the cervix. The colposcope looks like a pair of binoculars with a bright light and is mounted on a stand. A vinegar solution is swabbed on the cervix or area of concern in order to see the problem area more clearly. You may feel a cold or tingling sensation from the solution. A tissue sample (biopsy) may be taken at this time. Most patients describing a pinching or cramping sensation that lasts for several seconds. If a biopsy is done near the vagina or on the vulva, your doctor may use a local anesthetic to numb the area. A medication may be applied to the biopsy area to limit bleeding.

After the Procedure

If a biopsy is not taken, there is no restriction on your activity since your exam is complete. If a biopsy is taken, you can expect some light spotting for several days. You might also see a dark discharge from medication used to stop the bleeding from the biopsy site. You may need to wear a sanitary pad for the next few days. Do not douche, use tampons or engage in sexual intercourse for 48 hours. Continue taking your usual medications, including oral contraceptives.

It is rare to have problems after a colposcopy and biopsy. Rare risks include bleeding or an infection that will need treatment. Call your health care provider if you experience bleeding that is more than spotting (but not your period), fever and/or chills, heavy, yellow vaginal discharge that has a foul odor, or severe pain in your lower abdomen.

Getting Your Results

If biopsies were done, we will discuss the lab findings with you. The results may indicate that you need to have pap smears more often or that you need further testing or treatments. If you have abnormal results, your treatment will depend on the severity of cell abnormality. Your clinician may recommend waiting to see if the abnormal cells return to normal without further treatment. In this instance, you will have a repeat Pap test and possibly other tests to monitor the cells.

Another procedure may be prescribed if further treatment is needed. The following procedures are very effective at removing the abnormal areas and preventing cervical cancer:

  • LEEP: abnormal tissue is removed using a thin wire loop
  • Cryotherapy: abnormal tissue is removed by a freezing treatment
  • Laser: abnormal tissue is destroyed with a laser beam
  • Cone Biopsy: a cone-shaped wedge of tissue is removed with a scalpel in the operating room.

It is important to continue to get regular pelvic exams and Pap tests after you have been treated for abnormal cells. Even though cryotherapy, LEEP, laser, and cone biopsy are very effective, sometimes abnormal cells reappear after treatment.