Colposcopy-Directed Biopsy
Posted by: Solley on: July 29, 2008
A colposcopy-directed biopsy uses a low-powered microscope called a colposcope to help view the surface of the cervix and show abnormalities.
How the Test Is Performed
You will lie on a table and place your feet in stirrups to position your pelvis for examination. The health care provider will insert an instrument (speculum) into your vagina to open the vaginal canal and examine the cervix.
The cervix is then swabbed with a chemical solution (acetic acid) to remove the mucus that covers the surface, and to highlight abnormal areas. The health care provider will place the colposcope at the opening of the vagina, and examine the area. Photographs may be taken.
If any areas look abnormal, a small sample of the tissue will be removed (biopsy) using small biopsy forceps. Many samples may be taken, depending on the size of the area.
How to Prepare for the Test
There is no special preparation. You may be more comfortable if you empty your bladder and bowel before the procedure. You should not douche or have sexual intercourse for 24 hours before the exam.
How the Test Will Feel
A colposcopy is painless. Some women feel a slight sting from the vinegar solution. The biopsy may feel like a pinch each time a tissue sample is taken. You may have some cramping after the biopsy.
It is typical for women to hold their breath during pelvic procedures because they expect pain. Concentrating on slow, regular breathing will help you relax and help relieve pain.
Why the Test Is Performed
This procedure is usually done after a positive Pap smear to identify the abnormality.
Normal Results
A smooth, pink surface of the cervix is normal. A biopsy is only done when the health care provider sees or suspects abnormal tissues because of abnormal Pap smear results.
What Abnormal Results Mean
Abnormal results may indicate:
- Cancer
- Cervical intraepithelial neoplasia
- Cervical warts (human papilloma virus)
- Precancerous tissue changes
The colposcopy may be used to keep track of precancer and look for abnormalities that come back after treatment.
Abnormal findings during a colposcopy include:
- Abnormal patterns in the blood vessels
- Whitish patches on the cervix
- Areas that are swollen, worn away, or wasted away (atrophic)
Any of these problems may be signs of cancerous changes.
The test also may be done if an abnormal Pap smear shows signs of cervical dysplasia.
Risks
After the biopsy, you may have some bleeding for up to a week. To allow the biopsy area to heal, for 2 weeks avoid:
- Douching
- Sexual intercourse
- Using tampons
Call your health care provider:
- If bleeding is very heavy or lasts for longer than 2 weeks
- You notice any signs of infection (fever, foul odor, or discharge)
References
Katz VL, Lentz GM, Lobo RA, Gershenson DM. Katz: Comprehensive Gynecology. 5th ed. Philadelphia, Pa: Mosby; 2007.
Considerations
If the colposcopy or biopsy does not show why the Pap smear was abnormal, your health care provider may suggest that you have a more extensive biopsy.
See also: Cold knife cone biopsy
Illustrations
A colposcopy-directed biopsy is a procedure in which the cervix is examined with a colposcope for abnormalities and a tissue sample is taken.
External
structures of the female reproductive anatomy include the labium minora and majora, the vagina and the clitoris. Internal structures include the uterus, ovaries and cervix.
The uterus is a hollow muscular organ located in the female pelvis between the bladder and rectum. The ovaries produce the eggs that travel through the fallopian tubes. Once the egg has left the ovary it can be fertilized and implant itself in the lining of the uterus. The main function of the uterus is to nourish the developing fetus prior to birth.
Related Topics
Source: New York Times’ Health Guide
