A colposcopy is used to find cancerous cells or abnormal cells that can become cancerous in the cervix, vagina, or vulva. These abnormal cells are sometimes called “precancerous tissue.” A colposcopy also looks for other health conditions, such as genital warts or noncancerous growths called polyps. A special instrument called a colposcope gives your doctor a lighted, highly magnified view of the tissues that make up your cervix, vagina, and vulva. The colposcope is placed close to the body, but it does not enter the body.
A colposcopy can be done in the office of your primary care doctor or your gynecologist. After lying down on the exam table, you’ll place your heels in the stirrups at the end of the table. An instrument called a speculum will be inserted inside your vagina to open it up and give your doctor a clearer view of your cervix. Your cervix, vagina, and vulva will be lightly wiped with a vinegar or iodine solution that helps your doctor better see abnormal areas. The colposcope is positioned between your legs as close to your vagina as possible, but it never goes inside your body.
There are no direct side effects that a colposcopy will cause. However, if you have a biopsy during a colposcopy, then you could have a dark vaginal discharge for a few days. This comes from the solution doctors use to reduce bleeding that can happen with a biopsy. You may also have some bleeding, cramping, or soreness. If these or other symptoms get worse or don’t go away, or you have extremely heavy bleeding, severe pain in your lower abdomen or pelvis, or a fever after the examination, call your doctor immediately. Like before the colposcopy, don’t have vaginal sex or use any type of products or medications that go inside the vagina until your doctor says it’s OK.
LLETZ and cervical knife cone biopsy
Cervical excisions are utilised for the diagnosis and treatment of premalignant lesions and in some cases with limited invasion. Cervical excisions include cone biopsies and electrosurgical procedures (LLETZ and LEEP biopsies).
If your doctor finds precancerous cell changes in your cervical tissue, also known as cervical dysplasia, the area around the tissue may need to be surgically removed to reduce the risk of cancer and the spread of cancer. There are two common ways that this can be done: a cold knife cone biopsy and a Loop Excision of the Transformation Zone (LLETZ Procedure). Both of these procedures can be used to treat abnormal tissue that your doctor has found during a colposcopy or cervical biopsy, including:
- Moderate-severe precancerous cell changes
- Low-grade squamous intraepithelial lesions (LSIL). These are minor cell changes that do not resolve after a few months.
Vulvoscopy for vulval diseases
Colposcopy of the vulva—vulvoscopy—is an essential step in gynecology examination. However, it is not as systematic as colposcopic of the cervix examination due to the normal histology as this area and the multifocal nature of vulvar intraepithelial disease makes the examination more difficult and less objective than the cervix examination.
The successive aim is to identify the main clinical aspects of the lesion which can be summarized as changes of color, presence of swellings on surface, and loss of substance. The critical evaluation of lesions should allow critical evaluation of lesions and also allow the gynecologist to formulate a diagnosis to propose to the pathologist. In this way, the collaboration between clinician and pathologist can contribute to progress in the diagnosis and treatment of vulvar diseases.