Colposcopy

Definition

The exploration is carried out by visualizing this structure through a colposcope. This instrument is made up of a series of lenses of different magnifications, arranged like a telescope that, when approached to the vagina, provides a enlarged view of the cervix. Currently there are a multitude of colposcopes to which light sources, a photographic camera or video can be incorporated. Using a monitor, it is possible to obtain a direct display and record the images obtained. Its use has been extended to the exploration of the vaginal walls, vaginal introitus and perineum. It allows identify lesions, study the vascularization of the cervix and identify potentially malignant processes.

To complement the study, stains are applied to the cervix in order to reveal lesions that could go unnoticed by the naked eye. One of the most commonly used stains is the iodine-rich lugol solution or Schiller's test. The surface of the cervix or cervical epithelium is stained dark brown, except for the injured areas that appear whitish. When abnormal areas are identified, taking biopsies or samples may be helpful cervical tissue for further studies.

How is the study done?

The examination is carried out in a gynecological consultation. To the just like a regular gynecological check-up, the patient lies on the table in the gynecological position. The doctor proceeds to the examination of the cervix with the help of a speculum, which by means of two leaflets allows to widen the vaginal opening and facilitate direct observation. The colposcope is placed in front of the vagina but without coming into contact with it. Subsequently, the visualization can be optimized with the application of solutions to reveal the presence of lesions. Staining is usually done using a swab soaked in the solution that is gently applied to the cervix. The gynecologist may think it appropriate to perform a biopsy of the area after observing an abnormal area. In this case, local anesthesia will be applied to the area to be biopsied, with which the patient will only notice a slight prick. The proof usually lasts 5 to 10 minutes.

Preparation for the study

There's no need no prior preparation. It would be advisable not to insert anything into the vagina during the two days prior to the procedure, such as vaginal ovules or tampons to prevent these from altering the identification of abnormal cells. It is advisable avoiding examination during menstruation since it could make the exploration difficult.

What does it feel like during and after the study?

During colposcopy the same discomfort as a routine gynecological examination. In case of taking biopsies, you may notice a brief burning sensation at the time of application of anesthesia. If anesthesia is not applied due to the size of the injury, you may notice a small pinch. There may be residual discomforts that resolve in minutes or hours. If biopsies have been taken, you may have mild, self-limited bleeding.

Study risks

In case of carrying out any pharmacological treatment or presenting an allergy, the gynecologist should be informed. The patients who perform antiplatelet treatment (aspirin, clopidogrel, ticlopidine) or anticoagulant (heparin, sintrom) may present significant bleeding at the time of biopsy. One of the most commonly used stains during the examination is lugol iodine, which could lead to anaphylactic reactions in patients with an allergy to iodine.

Study contraindications

Is a safe test. Only the application of iodinated solutions will be contraindicated in allergic patients and the taking of biopsies in patients with anticoagulant treatment. The manipulation of the uterine cervix in pregnant women is also discouraged, and the gynecologist should be the one to individualize the indication for the test.

Reasons why the study is carried out

Colposcopy can be performed on any woman having a gynecological examination for the first time. It is also especially indicated when cervical cytology or Pap tests show any alteration that could suggest anything from an inflammatory process to a cancerous lesion.