Colposcopy and Cervical Biopsy

Colposcopy is a procedure performed through a device called a colposcope, which allows the gynecologist to have an enlarged and enlightened view of the vulva, vagina and cervix. Colposcopy is often used when the physician intends to perform a biopsy of the cervix.


In this article we explain what is colposcopy, as it is made, what are the indications and which are the possible complications of this examination.

What is colposcopy?

Colposcopy is a word of Greek origin, which can be translated as "viewing the vagina" or "visually examine the vagina". Colposcopy is actually a test that allows the doctor to examine not only the vagina but also the vulva (external part of the female genitals) and the cervix, much more thoroughly than in the common gynecological exam, which is done the naked eye.

Despite its name suggest some resemblance to more invasive tests such as colonoscopy or endoscopy in colposcopy there is no introduction of any device in the vagina of the patient. The colposcope is a device that looks more like a camera or binoculars, as you can see in the picture beside. There are at any time contact the colposcope with the genital region, this always getting about 30 cm away from the patient.

The advantage of colposcopy in relation to the common gynecological examination is that it be able to properly illuminate the vaginal canal and allow the gynecologist can view the region through magnifying lens, allowing lesions ID in the vagina mucosa and colon uterus that the naked eye can not perceive. The colposcope also allows the gynecologist to use color filters as a green or blue light to highlight changes in vascularization in the cervical region.

What good is colposcopy?

Colposcopy is an exam which serves to complement the common gynecological examination usually is indicated when the gynecologist finds necessary a more detailed assessment of the genital tract. In general, both situations indicate means of colposcopy, when the examination of the Pap smear shows some alteration suggestive of premalignant lesion or when during common gynecological examination gynecologist recognize any suspicious lesion in the lining of the vagina or cervix. In both cases, colposcopy is used so that the gynecologist can make a biopsy of the suspicious region.

How is made colposcopy?

Colposcopy does not differ much from the common gynecological examination. The patient lies down on the table with legs spread and the gynecologist introduces the speculum, also known as duck-billed in the vagina to view the inside. So far it's all the same as the patient is accustomed. With the aid of the colposcope, which as we have said often be about 30 cm away from the vulva, the doctor makes a careful assessment of the entire mucosa of the vagina and cervix. In general, one or more of the vagina mucosa biopsies and cervical are performed.

If the doctor can detect the colposcope any suspicious lesion, it will perform a biopsy of this lesion. If no obvious lesions, the gynecologist can use a colorant to facilitate identification of tissue to changes in its cells. The two most used techniques are the Schiller test which uses an iodine-based solution or test acetic acid, which as the name implies, uses a solution of acetic acid. If there are changes at the cellular level, with these dyes they become more apparent, helping the gynecologist to choose which areas of the cervix that should be biopsied.

If the last pap smear from the patient already has more than 6 weeks a new curettage of the cervix can be performed for the sample to be sent along with the biopsy material.

The complete examination lasts between 15-20 minutes and is painless. Some patients experience some discomfort at the time of passage of the speculum or during the biopsy, but in general, it's no big deal. No need anesthesia or sedation to perform colposcopy. Any spatial preparation for the exam is also not necessary.

Contraindications and precautions related to the realization of colposcopy

There is no absolute contraindication to performing colposcopy. However, care must be observed for the performance of colposcopy is optimized.

The first point is not to perform colposcopy during the menstrual period. The best time to perform colposcopy is the first half of the cycle, a few days after the end of menstruation.

It is also not indicated perform colposcopy in women known to have vaginal or cervical infection. The inflammation, discharge and bleeding can disrupt the correct visualization of the vagina and cervix. Inflammation can also cause the passage of the speculum is painful, making the most troublesome exam than expected. Therefore, it is suggested the treatment of any gynecological infection prior to the examination.

The colposcopy may be performed without any problem in pregnant women. However, both the biopsy and curettage should be avoided due to increased risk of bleeding and complications in pregnancy.

The biopsy also should not be performed in patients taking anticoagulants. If possible, the drug should be stopped before the procedure to minimize the risk of bleeding.

The patient will undergo a colposcopy should avoid sex in the two days before the test. Also not recommended the introduction of any object into the vagina, be it a tampon, creams, ointments or vaginal suppositories within 48 hours.

Complications of colposcopy

If compliance with the conditions described in the previous section, the risk of colposcopy of complications is very low. In fact, does not require colposcopy itself at no risk. What can cause complications is biopsy and curettage, which may cause bleeding or infection.

The incidence of complications is very low. The risk of bleeding in nonpregnant and without coagulation disorders patients is very small. The after biopsy, the gynecologist usually use a call Monsel solution, which helps to heal the injury, by stopping any bleeding that may occur.

The colposcopy with biopsy does not prejudge in any way the fertility of the patient.

Care after colposcopy

Some vaginal discomfort may occur in the first 2 or 3 days after the exam. Minor bleeding can occur for up to a week. Landslides are also common and may be dark in color if the doctor has used the Monsel solution.

It is suggested to avoid exercise in the first 24 to 48 hours after the procedure. Sexual intercourse should be avoided for at least 1 week. Vaginal douching and buffer should also not be used.

Your gynecologist should be contacted if you notice: heavy bleeding, fever, severe abdominal pain or vaginal region and landslides with very strong odor.

It is important to know that the biopsy usually takes and can only be available after 2 or 3 weeks.

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