What is Colposcopy?

Colposcopy is a special diagnostic method that allows detailed examination of the cervix, vagina, and vulva using a magnifying device. It is usually performed when abnormal cells are detected in a Pap smear test for further evaluation. This procedure is critically important for the early detection of precancerous cervical lesions.

Why is Colposcopy Performed?

• Abnormal Pap Smear Results: Applied in cases of cellular abnormalities such as ASCUS, LSIL, HSIL, and ASC-H.
• HPV Positivity: Performed for early detection in patients with high-risk HPV types.
• Cervical Erosion or Lesions: Conducted when abnormal appearances are detected during examination.
• Chronic Vaginal Bleeding/Discharge: Used in unexplained complaints.
• Suspicion of Cancer in the Cervix, Vagina, or Vulva: Used for visualization and biopsy.

How is Colposcopy Performed?

1. Preparation and Positioning: The patient is placed in the lithotomy (gynecological exam) position.
2. Speculum Placement: A speculum is inserted into the vagina to visualize the cervix.
3. Examination with Colposcope: The colposcope, positioned outside the body, magnifies and evaluates the cervix.
4. Staining of the Cervix: A 3–5% acetic acid solution is applied to highlight abnormal cells. Lugol’s solution may also be used.
5. Biopsy (if necessary): Small tissue samples are taken from suspicious areas and sent to pathology.
6. Endocervical Curettage (if necessary): A sample is taken from the cervical canal.

What to Expect After Colposcopy?

• ✔ Mild vaginal spotting or brown discharge may occur.
• ✔ Mild pelvic discomfort may occur if a biopsy is taken.
• ✔ Most patients can return to daily activities immediately.
• ✔ If advised by the doctor, avoid sexual intercourse and tampon use for 3–5 days.

Possible Risks of Colposcopy

• ✔ Mild bleeding or spotting
• ✔ Infection (rare)
• ✔ Short-term pelvic pain
• ✖ Severe bleeding, foul-smelling discharge, or fever require medical attention.

How Are Colposcopy Results Evaluated?

• Normal: No abnormal cells detected; no further intervention needed.
• Mild Changes (ASCUS, LSIL): Regular follow-up is recommended.
• Moderate to Severe Lesions (HSIL, CIN 2-3): If precancerous cells are detected, procedures such as LEEP or conization may be required.
• Suspicion of Cancer: Detailed evaluation and treatment planning are carried out.

Before and After Colposcopy

• Before: Avoid sexual intercourse, vaginal douching, and tampon use for 24–48 hours prior to the procedure.
• After: If a biopsy was performed, avoid heavy exercise, swimming pools, and the sea for a few days.
• ✔ It is recommended to have sanitary pads available on the day of the procedure.

Conclusion

Colposcopy is an important and safe diagnostic method for the early detection of gynecological diseases. For women with abnormal Pap smear results or HPV positivity, this procedure is vital in preventing serious conditions that may develop in the future. If your doctor recommends colposcopy, it is valuable as it provides an opportunity for early intervention.