Colposcopy

What is colposcopy?

Colposcopy is a simple, quick and non- invasive diagnostic tool to look closely inside the vulva, vagina, and cervix to detect the presence of abnormal cells in these areas. Colposcopy is both diagnostic and therapeutic as it can be used to aid relief to some of the symptoms. A specific instrument called the colposcope does the examination in this procedure.

Doctors recommend a colposcopy examination following abnormal Pap smear tests. Sometimes, during a pelvic examination and a cervical screening test, doctors might suspect an abnormality. It is here that colposcopy can confirm any doubts. Also, while performing a colposcopy, if the specialist finds abnormal cells, a tissue sample may be collected for biopsy.

What can a colposcopy procedure diagnose?

Colposcopy assists in the diagnosis of the following:

– Alterations in vaginal tissue
– Cervicitis, inflammation of the cervix
– Genital warts
– Alterations in the cervical tissue
-Changes in vulva

Why do I need to undergo colposcopy?

There are several reasons your healthcare provider may recommend a colposcopy. The reasons could be :

– A routine cervical investigation may have revealed the presence of abnormal cells, though they may not be cancerous. A colposcopy may be the best bet to assist in the diagnosis.

– Several screening tests have proved inconclusive.

– Inflamed cervix.

– Human papillomavirus or HPV infection.

– Cervix appearing unhealthy during a screening test.

-Abnormal bleeding from the vagina not connected with menstruation.

How do I adequately prepare for a colposcopy?

You may experience anxiety before and after the procedure. This is quite natural and it is good to adopt certain coping techniques to help you relax.

– Make sure you do not use any vaginal medications at least 48 hours before the procedure.

– Taking a painkiller before colposcopy helps relieve any pain and discomfort of the procedure.

– If you are allergic to medicines or injections do convey the information to your healthcare provider.

– If you have a medical history of a bleeding disorder, it is imperative to keep your doctor in picture.

How is colposcopy performed?

Colposcopy can be conducted in an outpatient clinic or a doctor’s office. It is usually performed by a specialist.

-The entire procedure is quick and does not take more than 20 minutes.

– While you lie on your back on a designated table, your feet are held in pelvic supports.

– Your healthcare provider uses a metal speculum to open the vagina and enable a view of the cervix.

– Using a cotton swab the vagina and cervix are wiped to take out any mucus. To spot the presence of abnormal cells, the specialist may use a special solution on the vagina and cervix.

– A colposcope which has a magnifying lens and, powerful light is positioned close to the vulva to enable an enlarged view of the inside of the vagina and cervix.

– The colposcope does not enter the vagina. The camera in the colposcope captures images of the vagina and cervix and relays images on a small screen which can be studied by experts.

– Upon finding the presence of any abnormal cells, the specialist may remove a small sample of tissue for biopsy in the laboratory. If the tissue sample is from the cervix, it is possible that you may experience some discomfort, pain or cramps.

– In the event of a vaginal biopsy, pain can be much more. Doctors may use a local anesthetic to numb the pain. It may cause minimal bleeding

What can I expect after colposcopy?

If you underwent a biopsy during colposcopy you may experience the following symptoms:

– Pain in the vagina or vulva which may settle in one or two days.

– Spotting for a few days.

– Discolored or dark vaginal discharge

– It is good to use a sanitary pad during this period. Tampons are not recommended. Your doctor may advise you against sexual intercourse for a certain period of time.

What else should I know about colposcopy?

There are few risks you should know about colposcopy although, it is an extremely safe procedure.  In very rare cases, there could be complications from the biopsies during this procedure.

Some of the complications could manifest as:
– Pain in the pelvic region
– Infection
– Excessive bleeding
– Fever
– Chills
– Unbearable pain in the abdomen
– Acute inflammation of the cervix
– Pelvic inflammatory disease
– You need to seek medical assistance immediately if you experience any of the above symptoms.

What are the benefits of Colposcopy as a cancer screening tool?

Cervical cancer screening with colposcopy is successful because cell changes can occur many years before cancer can develop. Identifying and treating these cell changes at an early stage can prevent cancer from even developing.

When will I get the results of the colposcopy test?

It is possible for the specialist to discuss the findings with you after the test.  You may be informed right away about the presence of abnormal cells in the cervix or vagina. The results of a biopsy take about a month to arrive.

What do the results mean?

In case your colposcopy results reveal malignancy, then it is imperative to begin treatment with a specialist. Early screening for cancer leads to better treatment outcomes.

According to statistics, nearly 4 out of 10 women that have undergone a colposcopy enjoy a normal result.

Nearly 6 out of 10 women who undergo a colposcopy portray abnormal cells in the cervix. This does not mean all abnormal cells are cancerous. However, without adequate treatment, these abnormal cells can turn cancerous

How is therapy offered through colposcopy?

Colposcopy can be used to offer treatment by way of removing cervical cells that are abnormal. A treatment called a large loop excision of the transformation zone (LLETZ) is used to remove abnormal cells.

A local anesthetic is used during the LLETZ procedure. A wire loop is heated with electric current and used to remove the abnormal cells. Time taken for this procedure is just a few minutes.

The good part is, LLETZ is 90% effective in doing away with the abnormal cells. Of course, a follow-up screening of the cervix is imperative.

Alternate names for LLETZ are loop excision, loop cone, loop diathermy or loop biopsy.

You may experience slight pain akin to period pain during this procedure, followed by slight bleeding which goes on for several days following this treatment. A pad must be worn.

If a larger area of the cervix needs to be treated, the procedure will take longer and you may need a general anesthetic.

Some other forms of treatment for abnormal cells detected during colposcopy are cone biopsy, cold coagulation, hysterectomy, laser treatment, and cryotherapy.

How much does Colposcopy cost in India?

The price of colonoscopy test depends on the hospital facilities and also the specialist who is going to perform the test. However, it ranges from Rs 10000 to 50000 in different hospital or test clinics across India.

Is it safe to undergo colposcopy during pregnancy?

Yes, it is safe. In case a cervical biopsy is being performed, it may not interfere with the pregnancy. Although after the first trimester, the risks of bleeding cannot be ignored if colposcopy is to be conducted.

Do I need to fast before a colposcopy examination?

In most cases, you need not be on an empty stomach before colposcopy. In case a biopsy is being performed under general or local anesthesia, you may need to fast for about 6 hours before the procedure.

How common is cervical cancer in India?

As per the recent findings, approximately 132,000 new cases of cervical cancer are diagnosed and 74,000 related deaths occur annually in India, accounting to nearly 1/3^rd of the global cervical cancer deaths.

How to manage anxiety during colposcopy?

– Highly anxious women may experience more pain and discomfort during colposcopy.

– High anxiety levels were also connected with women tending to miss the colposcopy appointment.

– Music was found to be a stress buster and helped women divert their anxious energy in a positive manner.

– Less than 1 in 1,000 women referred for colposcopy are found to have cervical cancer that requires immediate treatment.

What are some of the dos and don’ts of this procedure?