Colposcopy. What to expect when preparing for a colposcopy.

Colposcopy. What to expect when preparing for a colposcopy.

What is a colpscopy?

A colposcopy is a test your doctor might do if you have a pap test or HPV test that has come back abnormal.  It is a way for your doctor or medical provider to closely exam your cervix (I’ll go over what that is later)  to see if everything looks ok or if they need to check a biopsy.  IF you are going to have a colposcopy, we will go over what to expect when you get it done.

 

The cervix is located at the top of the vagina.

A colposcopy is a test that lets your provider closely exam your cervix.  Your cervix is the bottom part of your uterus.   It is located at the top of your cervix and serves as a conduit between your vagina.  In other words, it’s like a very tiny hallway from your endometrial cavity and vagina.  This allows blood from your period to come out, Sperm to come in, and if you are pregnant, it stretches open for a baby to come out.

A colposcopy starts out a lot like a pap. Attribution: nci-vol-8271-72
A colposcopy starts out a lot like a pap. Attribution: nci-vol-8271-72

Before going into what a colposcopy procedure is like, it’s important to know why you need it and what it is testing for, so I’m going to talk a little about that.     When you get a pap test, they are testing your cervix for not only cervical cancer but precancerous cells as well.  If you can catch cervical cancer very early, and even better, when it is only precancerous, not full-blown cancer, it is waaaaay easier to treat, which is why getting your pap smears regularly is so important.

You may need a pap if you have HPV, even if your pap is normal. 

Some people don’t have abnormal paps, but do test positive for something called HPV which stands for human papillomavirus.    HPV is a virus that is responsible for cervical cancer almost 100% of the time.   Most of the time, your body’s immune system can get rid of the virus on its own.   When it doesn’t, and it infects your cervix for a long time, it can cause cancer on your cervix.     So if you have a pap test that comes back abnormal, or if you test positive for HPV, you will likely be asked to come in for a colposcopy. There are a few other reasons your provider might choose to do a colposcopy, but most of the time, it’s just for an abnormal pap or positive HPV test.

Stages of cervical cancer. Attribution. nci-visual online.com

So Lets go over what to expect.

First of all, what is a colposcope.  In short, it is like a big magnifying glass that lets your medical provider take a really good, close look at your cervix.

this is a colposcope
A colposcope helps your provider to get a good view of your cervix

When you get to the exam room, your provider will probably just want to talk to you for a bit. This is a chance for he or she to get your medical history.  They might ask if you have ever had an abnormal pap, if you have every had cervical biopsies before, if you have ever had genital warts before or if you have had any other cancers in the genital tracts.   They might also ask you about previous pelvic surgeries, smoking history (smoking increased your chance of developing cervical

smoking increases risk of cervical cancer
Smoking can increase the risk of cervical cancer

cancer) if you take medications that make your blood thinner or if you have a bleeding disorder.  The important thing to remember here is that your doctor isn’t trying to embarrass you or judge you.  All their questions are simply to help them make the best decisions for your medical care.

After this, they usually step out and let you change.   They usually let you keep your shirt on and just have you get undressed from the waist down and give you a drape or sheet to place over you.

When they come back, they have you put your feet into the stirrups They will put the speculum inside your vagina, Just like you did when they collected your pap

Cervical Cancer
Source: Lolaia – Norberak egina, httpscommons.wikimedia.org

test.     From here, they might use a cotton swab to apply a liquid onto your cervix.  The liquid is called acetic acid.  Don’t be nervous because the name has acid in it…it’s actually a fancy name for vinegar.     This just helps them to see any anything abnormal a little more easily.    Then they get the colposcopy and use it to look very closely at the cervix.  Like I said, its like a magnifying glass. It shines a light on your cervix as well so that they can really get a good look.     If everything looks ok, they might apply a different solution on your cervix called Lugal or schiller solution to aid in aid in identifying abnormalities.   Sometimes, even changing the color of the light might help the provider identify abnormalities as well.

 If they don’t see anything abnormal then oftentimes,  that’s it.  You are all done.

If they don’t see anything abnormal then oftentimes,  that’s it.  You are all done.  If they see anything that looks unusual or abnormal or depending on the results of your pap test,  then they collect a small sample to send to the lab. This sample is called a biopsy.  Your provider will label the sample according to the position of the biopsy as if your cervix were a clock.  For example, if the biopsy is taking from the very top of your cervix, the sample will be labeled as the biopsy at 12:00. AT the lab a doctor who specializes in diseases, particularly what diseases look like under microscopy, called a pathologist, will look at your biopsy under a microscope to see if there are any precancerous cells, if so, how advanced is it.

Many people ask, will the biopsy hurt?

Many people ask, will the biopsy hurt?  Some people feel like when they get a biopsy, there is a small, quick pinch, some people just feel a little pressure.     Don’t worry about that though, if you feel anything, it only lasts for a quick second and then goes away.  If you are nervous, you can ask your doctor if you can take some over the counter pain reliever beforehand, but I don’t think that is really necessary.

After the colposcopy is done, you can get dressed and go home.  If you get a biopsy, It usually takes 7-10 days to get the results back from the lab.  So try not to think or stress about.  When your doctor’s office calls you, they will tell you the results and what, if any, needs to be done next.

It might feel scary

It might feel scary to get a call saying that your pap is abnormal and that you need to come back for a colposcopy,  but I want to emphasize to you to not be scared.    You are already doing the right thing because you went in to get a pap test in the first place, so good job for being responsible and proactive for your health.     Your doctor will help you through this process.   Hopefully,  the colposcopy will be normal and you can go home knowing everything looks good.  However, you will likely have to do paps a little more often for a  while, your doctor will let you know when you can go back to regular pap tests intervals.

 

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