All About Colposcopy
Learn about colposcopy and how it helps diagnosing cervical cancer. Know the pre and post-operative procedure and its side effects for better decision making.
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Last updated on 3rd Jul, 2025
Colposcopy is a minimally invasive procedure used to examine the cervix closely through powerful magnification. Combined with tissue biopsy, it has expanded the field of cervical cancer screening and helped progress from conventional techniques. The first colposcope was developed in 1924 by Hans Hinselmann, after which several scientists contributed to its development, ensuring more accurate results with higher precision.
Indications for Colposcopy
Doctors look for special indications before they decide to perform colposcopy for further evaluation of the cervix and determination of any abnormality in the organ’s internal structure.
Abnormal Pap Smear Results
If the Pap smear results are abnormal, doctors can recommend this procedure to diagnose:
Presence of genital warts
Growth of non-cancerous polyps in the cervix
Cervicitis or the inflammation of the cervical lining
Precancerous changes in the vaginal or vulvar cells
Visualising Cervical, Vaginal, And Vulvar Lesions
If the doctor discovers any unexpected lesions in the cervix, vagina, or vulva, colposcopy will be recommended. It helps in better visualisation of the affected cells under high illumination and powerful magnification. This allows doctors to determine if the lesions are cancerous and need further biopsies or not.
Preparing For a Colposcopy
Before colposcopy is performed, patients are instructed to follow a few specific guidelines and prepare themselves for the procedure so that the results can be as accurate as possible.
Pre-Procedure Instruction for Patients
Patients will be instructed to not have any vaginal intercourse, at least for two days before the colposcopy procedure.
The use of tampons is strictly prohibited.
Individuals may be instructed to take pain relievers before the scheduled appointment.
Women will also be asked to avoid taking any vaginal medicines.
Discussion about Potential Risks and Complications
Healthcare providers provide detailed insights into the potential risks and complications of colposcopy, such as:
Heavy bleeding during or after the procedure
Risks of infection
Mild to medium-grade pain in the pelvic region
The Colposcopy Procedure
During the examination, the doctor will use the magnified lenses of the colposcope to visualise the cervical tissues and, if needed, will extract tissue samples for biopsies. Here is a detailed outline of the process –
Step 1: The patient needs to lie down on the back, with both legs spread, similar to that of a Pap smear test.
Step 2: A plastic or metal speculum will be inserted to keep the vaginal walls apart and in position throughout the examination.
Step 3: The colposcope will then be placed near the vulva with a few inches gap.
Step 4: The doctor will then use the bright light to illuminate the cervix and look into it through the powerful magnifying lens of the colposcope.
Step 5: The inner walls of the cervix and vagina can be rubbed with a vinegar solution to remove mucus and increase the visibility of lesions or suspected tissues.
Step 6: The healthcare provider may take a small tissue sample for biopsies. A small solution will be applied to prevent bleeding from where the tissues were removed using a sharp instrument.
Usually, two types of biopsies can be performed on the tissue samples taken during colposcopy, namely vaginal and cervical biopsies.
Understanding Colposcopy Results
It takes approximately 10 days for the biopsy results to come back, and normal findings of colposcopy indicate the cervix is in good health and there is no cancerous or non-cancerous growth of cells. Abnormalities in the examination findings may indicate:
Cervical polyps
Genital warts
Cervical intraepithelial neoplasia
Cervical cancer
If the biopsy results are abnormal, women then need to follow up with their healthcare provider for further treatments. Some of the best procedures conducted to treat the abnormal cells found in the cervix through colposcopy are:
Abnormal tissue removal using laser
Cone biopsy
Loop electrical excision procedure
cryotherapy
Risks and Side Effects of Colposcopy
Although colposcopy is a minimally invasive procedure, there are certain risk factors one should know about. This can help manage any post-procedure complications and contact the healthcare provider as soon as possible.
So, some of the common and rare side effects of this process are –
Bleeding from the cervix or vagina that can last for 2 weeks or more
Mild pelvic pain
Cramping in the lower abdomen due to cervical biopsy
Signs of infection like foul smell or a dark-coloured vaginal discharge
Following the colposcopy procedure, one can have mild pelvic pain lasting for a couple of days. Taking over-the-counter medicines can help relieve the aches. However, if any biopsy has been conducted, it may take 2 to 3 days to recover, during which one can expect slight bleeding. Also, if Monel’s solution or silver nitrate was used to stop the bleeding during the procedure, one can expect to see dark-coloured vaginal discharge.
Advances in Colposcopy Techniques
With the intent of improving the accuracy of cervical cancer screening, several advancements have been made to the traditional colposcopy technique.
Technological Innovations
A digital colposcope allows healthcare providers to examine the cervix through a digital screen and identify abnormalities with higher precision. Digital images of the cervix can also be recorded and used in the future to monitor the patient’s health condition and track overall progress.
Integration of AI
AI methods like deep learning algorithms can help learn the features of cervical or vaginal lesions from past colposcopy images. If integrated with digital colposcopy, the procedure can be automated.
Patient Experience and Concerns
Talking to the healthcare provider about the upcoming colposcopy procedure or the risks involved can help address the concerns properly and reduce anxiety levels. Usually, doctors thoroughly explain the entire colposcopy procedure and the potential complications you can face so that patients can feel less anxious. Besides, they also ensure all the concerns about safety and the biopsy findings are addressed properly.
At the same time, patient education about colposcopy is crucial to understanding the importance of this examination in detecting and treating cervical cancers, genital warts, cervical polyps, and other conditions on time.
Future Directions in Colposcopy
Thanks to ongoing research and studies, the colposcopy procedure has become more advanced. This allows healthcare providers to screen the cervix for abnormalities with greater accuracy and precision.
Emerging Research and Techniques
Digital video colposcopy
AV magnivisualiser
AI-integrated colposcopy
Liquid-based and automated cytology
Based on the new findings and advancements, there can be potential modifications in the clinical guidelines associated with colposcopy, surveillance, and treatment methods.
Conclusion
Colposcopy can help detect any underlying abnormalities in the cervix and vagina that can be associated with both cancerous and non-cancerous growths and lesions. This minimally invasive procedure allows healthcare providers to determine the root cause of abnormal Pap smear tests and recommend accurate treatment options.
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