Sunday, March 29, 2009

What Happens During: Colposcopy

I've had to call a few patients this week to tell them that their last pap smear was abnormal, and that they need to go for colposcopy. Since they inevitably Google "colposcopy" and call me back with a ton of questions, I wanted to put together a primer on what to expect at the appointment.

What is colposcopy, anyway?
Colpo (the gyno's affectionate nickname for the procedure) is a way of assessing if your pap smear was right, in saying that there's abnormal cells on your cervix. Not everyone with an abnormal pap really has a problem, and colpo tells the difference.

What happens when I go?
Your gyno will use a usual size-and-shape speculum (most often metal) to expose your cervix. She may open it a bit wider than usual to really get a good view. She may then test you for STDs if you haven't recently been tested, with a cotton swab in your cervix. Next, she'll apply a clear solution (acetic acid--which is actually vinegar) to your cervix with large cotton swabs or sponges. She's looking for any areas on your pink cervix that turn white--abnormal cells absorb the vinegar and turn white.

What happens if she sees something abnormal?
Your gyno will take a biopsy of any area that looks suspicious. A biopsy is removal of a small (a few millimeters) area of your cervix. TIP: ask her if you can cough as she takes the biopsy--believe it or not, it will hurt less. After the biopsies, she'll likely do a scraping of the cervical canal, to sample cells that she can't see. This will also cause cramping, but only for 5-10 seconds.

What happens after the colposcopy?
Your gyno will make sure that all the biopsy sites have stopped bleeding before she lets you go home, though some light bleeding at home is normal. It usually takes about 2 weeks for results. Your follow-up is dependent on what the results show:
  • All biopsies negative. You'll likely have pap smears every 6-12 months for 2 years, to be sure that nothing was missed on colpo.
  • Biopsy shows a low-grade abnormality. Likely pap smears every 6 months, with a repeat colpo if things don't resolve on their own.
  • Biopsy shows a high-grade abnormality. Then it's time for a larger biopsy procedure, called a LEEP or a cone biopsy.
Have you had an abnormal pap smear? Do you have any questions or worries about colposcopy?

Photo Credit: The Doctr

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