What is a colposcopy?

When cervical or vaginal problems are found during a pelvic examination, or abnormal cells are found during a Pap test, a colposcopy may be performed. Colposcopy is a procedure that uses an instrument with a magnifying lens and a light, called a colposcope, to examine the cervix (opening to the uterus) and vagina for abnormalities. The colposcope magnifies the image many times, thus allowing the physician to see the tissues on the cervix and vaginal walls more clearly. In some cases, a cervical biopsy, a small sample of tissue, may be taken for further examination in the lab. A colposcopy procedure may also be used to diagnose and assist in treating bleeding, polyps (benign growths), genital warts, or diethylstilbestrol (DES) exposure in women whose mothers took DES during pregnancy.

Related procedures that may be used to diagnose or treat cervical and vaginal conditions include Pap test, cervical biopsy, and loop electrosurgical excision procedure (LEEP).

What will happen during the procedure?

Generally, a colposcopy follows this process:

  1. You will be asked to undress completely or from the waist down and put on a hospital gown.
  2. You will be instructed to empty your bladder prior to the procedure.
  3. You will lie on an examination table, with your feet and legs supported as for a pelvic examination.
  4. Your physician will insert an instrument called a speculum into your vagina to spread the walls of the vagina apart to expose the cervix.
  5. The colposcope will be placed at the opening of your vagina. The colposcope does not enter your vagina.
  6. Your physician will look through the colposcope to locate any problem areas on the cervix or in the vagina. Photographs with the colposcope or sketches of any areas may be made for your healthcare record.
  7. Your cervix may be cleansed and soaked with a vinegar solution, also called an acetic acid solution. This solution helps make the abnormal tissues turn white and become more visible. You may feel a mild burning sensation. An iodine solution may be used to coat the cervix, called the Schiller test.
  8. Your physician may take a small tissue sample called a biopsy. When this is done, the physician first numbs the area but you may feel a slight pinch or cramp as the tissue is removed.
  9. Cells from the inside of the cervical canal may be sampled with a special instrument called an endocervical curette. This may also cause some cramping.
  10. Bleeding from the biopsy site may be treated with a paste-like topical medication or with a pressure dressing.
  11. The tissue will be sent to a lab for examination.

Are there any risks?

As with any surgical procedure, complications may occur. If a colposcopic biopsy is performed, some possible complications may include, but are not limited to, the following:

  • Infection
  • Bleeding

After the procedure

After a colposcopy procedure, you may rest for a few minutes before going home. If you have a colposcopy with a biopsy, the recovery process will vary, depending on the type of biopsy performed and the type of anesthesia (if any) used. If you received regional or general anesthesia, you will be taken to the recovery room for observation. Once your blood pressure, pulse, and breathing are stable and you are alert, you will be taken to your hospital room or discharged to your home. If this procedure was performed on an outpatient basis, you should plan to have another person drive you home.

You may want to wear a sanitary pad for bleeding. If a biopsy was performed, it is normal to have some mild cramping, spotting, and dark or black-colored discharge for several days. The dark discharge is from the medication applied to your cervix to control bleeding.

If a biopsy was performed, you may be instructed not to douche, use tampons, or have intercourse for one week after the procedure, or for a period of time recommended by your physician. You may also have other restrictions on your activity, including no strenuous activity or heavy lifting. You may resume your normal diet unless your physician advises you differently. Take a pain reliever for cramping or soreness as directed by your physician.

Generally, women who have had a cervical biopsy will need more frequent Pap tests. Notify your physician if you have any of the following:

  • Bleeding
  • Foul-smelling drainage from your vagina
  • Fever and/or chills
  • Severe pelvic (lower abdominal) pain