Colposcopy is an office procedure in which the cervix is visualized with a low power microscope and high intensity light. Colposcopy may be recommended for an abnormal Pap test, a persistently positive HPV test, cervical or vaginal warts, persistent spotting after intercourse, and unexplained spotting between periods or other reasons.
The procedure is performed in our special procedure room, which is larger than our standard exam rooms and has a power table. The doctor inserts a standard vaginal speculum and then positions and focuses the microscope for optimum viewing. Acetic acid (a dilute vinegar solution) is applied to make abnormal areas easily visible so that they can be pinpointed for biopsy. Acetic acid shrinks the cytoplasm of the cells, so that cells which have a large nuclear/cytoplasmic ratio will stand out. Cells that are abnormal (atypical) tend to have a larger nuclear/cytoplasmic ratio. Biopsies are then taken according to what is seen through the microscope. A cervical biopsy is uncomfortable, but generally tolerable. Anesthesia is not typically necessary. Sometimes a scraping of the inside of the cervix (an endocervical curettage or ECC) is done. This causes some brief cramping and discomfort. After the procedure is complete, Monsel’s solution (ferric subsulfate) is applied to stop any oozing. A tampon may be placed, or a pad supplied, depending on preference. Your doctor or nurse will call with your results in about 7 days. If you do not hear within this time frame, you should call us to request your results. Because of the discomfort associated with this procedure, we ask you to take 800 mg ibuprofen about a half hour prior to your appointment time.
Possible complications are bleeding, cramping and infection. Serious complications are rare. Some cramping and bleeding is to be expected. If it seems out of the ordinary, is increasing in severity, or is accompanied by fever >100.4º, please call our office (telephone answered 24 hours).