Colposcopy

The procedure of examining the tissues of the cervix, vagina and vulva with the help of a microscopy or a special magnifying glass resembling binoculars is called colposcopy and this device, which is examined, is called colposcope. This lighted and computerized device used in the examination enlarges the image of the cervix. Thus, it provides a better examination and view of the cervix. With colposcopic examination, small pathologies (changes in cell and vascular structure) that cannot be observed with the naked eye are detected, and the findings recorded in subsequent treatments are used. During the procedure, some dyes and substances are applied to the cervix to make the suspicious areas more prominent and to identify these areas where biopsy should be taken.

Who Can Have Colposcopy?

• ▪       Women with abnormal cells detected as a result of the smear test
• ▪       Women with positive ASCUS, ASC-H, LGSIL, HGSIL, HPV values ​​as a result of the smear test.
• ▪       Women who have an abnormal condition during gynecological examination
• ▪       Women who need to be able to clearly examine small pathologies and precancerous lesions that cannot be clearly observed with the naked eye.
• ▪       Smear test is an appropriate test for community screenings. It is economical and can be easily administered by any healthcare professional.
• ▪       Smear test and HPV test is a screening test. It is still the cheapest and most effective screening test for the diagnosis of cervical cancer and precancerous lesions.
• ▪       Smear test is a screening test, not a diagnostic test. For the definitive diagnosis of patients with abnormal smear tests, biopsy should be taken from the cervix under colposcope.

Wondering About the Transaction

• ▪       Since the colposcopy procedure is a painless and painless procedure, patients do not need to be anesthetized with general anesthesia.
• ▪       If a biopsy sample is taken after the procedure, it is normal to feel mild groin pain or cramping.
• ▪       No vaginal medications or vaginal tampons should be applied 24 hours before the procedure and sexual intercourse should not be performed.
• ▪       It is normal to experience spotting bleeding or dark colored vaginal discharge for 2-3 days after colposcopy.
• ▪       Sexual intercourse and vaginal tampons should not be used for at least 1 week after the procedure.
• ▪       Patients with abnormal findings as a result of the pathological examination of the biopsies; They can be treated with operations called conization or LEEP, or they can be followed periodically with smear test.

How Is Colposcopy Performed?

During colposcopy, a speculum is used to see the vagina and cervix, just like in a normal gynecological examination. The cervix and vagina are observed with a colposcope. The main area evaluated in the examination is the area where the cell layer forming the outer part of the cervix and the cell layer forming the channel extending into the uterus are joined. This area is called the squamo-columnar junction or transformation zone. Cervical cancers start from this area. This area should be fully evaluated. Incomplete evaluation is considered to be insufficient colposcopy.

One of the important points during the procedure is to observe the vascularization in the cervix. This evaluation is made using the green light on the colposcope device after the cervix has been cleaned with saline solution. Biopsy should be taken from areas with irregular vascularity.

Acetic acid between 3% and 5% is applied to the cervix for further evaluation. Acetic acid application can be made more than once depending on the length of the process. Although this procedure may cause a slight burning, it is not a painful procedure. If there are areas containing abnormal cells in the application area, these areas turn white. These areas are called aceto-white areas. Biopsy should be taken from these areas. Biopsy can also be taken from ulcerated lesions in the examination area.

In some cases, the examination is continued with an iodine solution called lugol's solution. (Schiller Test) Areas not stained with Lugol's solution are abnormal areas and require biopsy.