What is Colposcopy?
BDS (Bachelor of Dental Surgery), 6 years of experience
Colposcopy Meaning
Colposcopy is a diagnostic test to primarily detect cervical cancer in addition to other cervical abnormalities after abnormal results are seen post cervical screening through Pap smear.
In this procedure, the gynecologist examines the vagina and the external part of the cervix leading to the vagina, also called the exocervix, for signs and symptoms of the disease. During this procedure, the doctor uses a special instrument called a colposcope. If the doctor finds an unusual mass of cells during the colposcopy procedure, a sample of tissue can be collected and sent for laboratory testing (biopsy). This procedure is called Colposcopic Biopsy. After the results of the biopsy are out, appropriate treatment can be done. Based on the results of the biopsy, the condition is treated.
Let us tell you in detail about colposcopy in today’s article.
- What are the tests done before Colposcopy?
- When is Colposcopy done?
- Why is Colposcopy done?
- What are the precautions to be taken before Colposcopy?
- How is Colposcopy done?
- How to take care after a Colposcopy?
- Special Cases: What should be done?
- What are the risks of Colposcopy?
- What are the possible results of Colposcopy?
- What are the follow-ups done after a cervical cancer Colposcopy report?
- Why is Colposcopy advised over other procedures?
- What is the cost of Colposcopy in India?
- Which tests can be done if Colposcopy is unaffordable?
What are the tests done before Colposcopy?
Before we understand when a Colposcopy is done, we need to know about the tests that lead up to this.
Cervical cancer happens to be the fourth most common cancer in women, worldwide. In 2018, approximately 5,70,000 women were diagnosed with cervical cancer out of which about 3,11,000 women lost their lives to this disease.1 Cervical screening is thus paramount.
- The main screening test used for this purpose is called the Pap test or the Papanicolaou test. A Pap smear test is just a screening test whereas a Colposcopy is a diagnostic test that is used for the confirmation of diagnosis which is necessary for treatment to be started.
- Another test undertaken is the HPV DNA which stands for Human papillomavirus DNA test.
According to the FIGO (The International Federation of Gynecology and Obstetrics) guidelines, a Pap smear test should be started at 21 years of age irrespective of sexual activity. The screening should be done every 3 years if only Pap test is conducted and should be done every 5 years in case both Pap smear and HPV DNA are conducted simultaneously, in which case it is called Co-test.
When is Colposcopy done?
A pap smear test is the first test performed in case of both routine examinations of the cervix and examination due to abnormal symptoms. The test may show normal or abnormal cell growth. If a pap smear test is performed and the result is abnormal but growth is visible, a biopsy is done. However, if after abnormal results the growth is not visible then a Colposcopy is advised, after which a Colposcopic biopsy is undertaken. This test is necessary for diagnosing cervical lesions, mainly Cervical Cancer. ( Know more about- What is Cervical Cancer? Causes, Symptoms, Treatments, Cost )
Why is Colposcopy done?
A Colposcopy is done using a Colposcope which is a magnifying instrument that can give better visualization to the lesions of the Cervix that were previously undetectable through a pap smear test. They are mainly done to diagnose cervical cancer but also used to detect other cervical abnormalities and pre-cancerous lesions.
It may be advisable to have a colposcopy in some women based on symptoms like:
- Cervical pain
- Unusual fluid discharge from the vagina
- Abnormal discharge
- Excessive vaginal discharge, pain experienced during sexual intercourse
- Abnormal bleeding
- Unexplained, persistent pelvic pain with or without back pain
Some of the conditions diagnosed through this test are:
- Cervicitis
- Cervical cancer
- Genital warts ( Know more about- What is Genital Herpes? Causes, Symptoms, Treatment )
- Vulvar cancer
What are the precautions to be taken before Colposcopy?
Colposcopy examination is done for several diseases of the vulva and cervix. It is a fairly common procedure but some precautions are necessary:
- The patient should not take any vaginal medication for at least two days before the colposcopy
- The patient should avoid having intercourse some days before the procedure
- Tampons shouldn’t be used a few days prior to the procedure
- Over-the-counter medication like pain relievers like ibuprofen (Advil, Motrin IB, others) or acetaminophen (Tylenol, others) shouldn’t be taken before the procedure
The patient shouldn’t schedule a colposcopy during her menstrual period
How is Colposcopy done?
- During colposcopy, the patient sits on a chair and keeps the legs wide open to access the vagina. The doctor opens the walls of the vagina to view the cervix.
- Colposcope is a magnifying instrument that is used to examine the cervix. Usually, this testing procedure takes only 10 to 20 minutes.
- The doctor places a metal speculum in your vagina. The speculum is used to hold open the walls of your vagina so that your doctor can see your cervix. ( Know more about- What is Vaginal or Vulvar Cancer Treatment? )
- A colposcope magnifies the parts and thus helps the doctor locate the abnormal regions.
- A Colposcopic Biopsy is also taken if necessary.
How to take care after a Colposcopy?
- After colposcopy, the patient should take it easy for the first 24 hours and avoid heavy work or exercise such as vacuuming, golf, or swimming for a few days.
- Vaginal discharge is normal for four to six weeks after the colposcopy procedure. At first, this discharge is reddish-brown, and then it changes during healing.
- You can contact your doctor in case of any complications. ( Know more about- What is Vaginal Irritation? Causes, Symptoms, Treatment, Home remedies )
Special Cases: What should be done?
- In case of a lower grade lesion which is a mild abnormality in a pregnant female, the doctor advises the patient to wait for 6 weeks before ignoring it
- In case of a high-grade abnormality in a pregnant female, colposcopy and biopsy are done
- If the Pap smear is normal but HPV DNA is positive, Co-test should be repeated in 12 months and Colposcopy if HPV DNA persists
- Pap smear shows a lesion but colposcopy is abnormal
What are the risks of Colposcopy?
Colposcopy is usually a safe procedure with minimum risks or complications. But in some cases, complications from biopsies taken during colposcopy can occur such as:
- Heavy bleeding
- Infection
- Pelvic pain ( Know more about- Home Remedies for Pelvic Pain )
If you experience any of these symptoms after colposcopy, contact your doctor immediately:
- Bleeding that is heavier than what you experience during your usual period Chills
- Fever
- Severe abdominal pain ( Know more about- Normal Delivery Abnormal Bleeding )
What are the possible results of Colposcopy?
Your doctor or nurse can tell you the findings of the colposcopy examination. The result can be either normal or abnormal.
- If you have abnormal cells, then the doctor may recommend treatment to remove these cells immediately.
- Also, if the result is not clear, then your doctor may advise a biopsy. In this, a small tissue sample is taken from your cervix for laboratory testing.
- In the case of Cervical Cancer, the results on paper appear as CIN1, CIN2, CIN3 in which the CIN stands for Cervical Intraepithelial Neoplasia which is a precancerous lesion and the numbers indicate the stage of cancer. The treatment and follow-ups differ from stage to stage.
What are the follow-ups done after a Cervical cancer Colposcopy report?
- In the case of CIN1, follow-ups are required for two years wherein Co-test ie. Pap smear tests and HPV DNA tests are done yearly.
- If it persists beyond 2 years then an OPD procedure called Cryoablation is done where the tissues are destroyed using cold gas- N2O and CO2.
- In the case of CIN2 and CIN3, the abnormal tissue is removed.
What is the cost of Colposcopy in India?
The total cost of the colposcopy procedure in India can range from around INR 20,000 to INR 40,000. Many big hospitals with specialized doctors in India offer colposcopy examinations. But the cost varies across different hospitals.
If you are coming from abroad, apart from the expenses of the colposcopy examination, there will be an additional cost of living in a hotel, the cost of food, and the cost of local travel. Apart from this, after the procedure, the patient has to stay at the hospital for a day for recovery. So, the total cost of the colposcopy procedure in India comes to a total of INR 60,000 to INR 75,000.
Which tests can be done if Colposcopy is unaffordable?
In rural areas, a Colposcopy is almost never done. Owing to the exorbitant cost of the test, doctors recommend other tests to patients from the lower socio-economic group. Two of those tests are as follows:
- VIA: Visual examination of the uterine cervix is done after applying 3-5% acetic acid. If an abnormal load of proteins is present in the cervical epithelium, the acetic acid reacts with the protein to give an opaque appearance. A precancerous lesion has a higher protein quantity. As a consequence, it becomes white which is called Acetowhite and is considered to be “VIA positive”. The areas that do not show the stain are normal.
- VILI: Visual examination is done after the VIA test. In this test, Lugol’s iodine is applied. This reacts with glycogen, a form of glucose, and gives rise to brown or black coloration. Normal cervical areas contain glycogen. When Lugol’s iodine is in contact with the normal areas they become black, while the precancerous areas and cancerous areas do not get stained. This reaction is said to be “VILI positive”.
We hope that we could answer all your questions regarding Colposcopy through this article.
If you want any other information and procedure of Colposcopy done, you can contact a Gynecologist.
We only aim to provide you with information through the article. We do not recommend any medicine or treatment to anyone. Only a qualified doctor can give you good advice and the correct treatment plan.
