Colposcopy of the cervix
Colposcopy of the cervix is ​​a procedure that is prescribed to most women, only few people know what it is for. Together with experts, we will figure out how cervical colposcopy is performed, how to prepare for it, what indications and contraindications the procedure has

What is a colposcopy of the cervix

Colposcopy of the cervix is ​​its visual examination (examination) using a colposcope and diagnostic tests1. The colposcope is an optical device with multiple magnification and internal illumination, which allows you to examine in detail the condition of the mucosa and blood vessels.1. Colposcopy can diagnose most diseases of the cervix, including those that are asymptomatic1. The technique is widely used for early diagnosis of cancer and precancerous conditions and allows to detect malignant changes that are not visible to the naked eye.2.

Indications for colposcopy of the cervix

Preventive colposcopy is recommended for all women every year, even in the absence of complaints. The fact is that many gynecological diseases do not manifest themselves in any way, so they are difficult to detect during a standard examination. In addition, cervical colposcopy is prescribed in the following cases:

  • with suspicion of oncology or a precancerous condition;
  • with a chronic inflammatory process on the cervix (cervicitis);
  • with leukoplakia or hyperkeratosis, when the integumentary epithelium of the cervix thickens and becomes keratinized;
  • with ectropion or deformation of the cervix;
  • upon detection of genital warts;
  • with ectopia, when the cells of the internal mucous membrane of the cervix come to its surface;
  • when a woman complains of intermenstrual spotting from the genital tract;
  • in preparation for pregnancy and IVF.

Colposcopy is performed to make an accurate diagnosis, prescribe treatment and monitor its results. Also during the procedure, the doctor decides on the need for additional studies, for example, a biopsy with further analysis of the samples.

Contraindications for colposcopy of the cervix

The standard procedure has no direct contraindications, and all restrictions are temporary. Extended colposcopy with diagnostic tests is not performed if the patient is allergic to chemical solutions1.

Temporary contraindications include the following conditions:

  • menstruation;
  • acute inflammatory process in the vagina and on the cervix;
  • recovery period within 1-2 months after childbirth, abortion and surgery on the pelvic organs.

There are no other restrictions on the procedure. But it should be borne in mind that the results of the study will be informative only with proper preparation.

Preparation for colposcopy of the cervix

A gynecologist usually tells about the features of preparing for a colposcopy of the cervix. The optimal time for examination is the first 3-4 days after the end of menstruation (until the 10th day of the menstrual cycle). When preparing for a colposcopy of the cervix for 2-3 days, several recommendations should be followed:

  • do not use vaginal suppositories, tampons, sprays;
  • refuse sexual intercourse;
  • do not take tests that are associated with taking a smear from the vagina and cervix;
  • do not douche;
  • use plain water and soap for personal hygiene.

Immediately before the examination, a simple washing of the external genital organs is performed and at the same time, make sure that the soap solution does not get inside the vagina.

How is a colposcopy of the cervix performed?

The procedure is performed on a gynecological chair. The doctor inserts a speculum into the patient’s vagina and fixes it in the desired position.3. After that, the cervix is ​​examined through a colposcope – a binocular microscope with a lighting device.2,3.

During the examination, the colposcope is located at a distance of 10-15 cm from the external genitalia2,3. The device has a magnification control, so the doctor can examine all areas as close as possible2,3. Usually, during the procedure, a smear is taken for oncocytology, papillomavirus and sexually transmitted infections. When using digital equipment, the image from the colposcope is transmitted to the monitor and recorded.

Standard colposcopy includes visual examination with smears3. With extended colposcopy, the doctor additionally performs diagnostic tests using various chemical solutions. If, during the examination, areas with pathological changes are found on the cervix or in the vagina, a biopsy is performed – tissue sampling for histological examination3.

Where is a colposcopy of the cervix performed?

The diagnostic procedure is performed on an outpatient basis and in a hospital. You can undergo an examination in a antenatal clinic, a maternity hospital, a private medical center, a sanatorium.

Interpretation of the results of colposcopy of the cervix

The results of the examination are drawn up in the form of a protocol and issued on a form. The protocol indicates the age of the patient, complaints, existing diseases, the number of births and abortions, the date of the last menstruation. This information helps the doctor to give a more accurate conclusion. For decoding, a special table is used, which lists the changes characteristic of benign and malignant processes.

The following terms may appear in the conclusion:

  • atypical vessels – they are irregular in shape and remain visible after contact with acetic acid, which may indicate the likelihood of developing an oncological process;
  • iodine-negative epithelium – pathological areas of the mucosa that are not stained with Lugol’s solution;
  • punctuation – small vessels over the entire surface of the mucosa, which is typical for precancerous conditions;
  • mosaic epithelium – a mesh of reddish lines that appears during malignant degeneration of tissues;
  • dysplasia – a change in the mucosa under the influence of papillomavirus, which often becomes the basis for a malignant tumor;
  • genital warts – genital warts, a sign of infection with papillomavirus;
  • leukoplakia – keratinized areas of the mucosa, which can degenerate into malignant neoplasms.

This is an incomplete list, since pathological changes are very numerous and varied. Knowing the terms will help you understand the results, but the doctor should deal with the decoding and diagnosis. He, if necessary, will prescribe additional studies and treatment.

How much does a cervical colposcopy cost?

The price depends on the region, the equipment used, the complexity of the procedure and the availability of additional services. An extended colposcopy is more expensive than a regular one. The price will be higher if tissues are taken for a biopsy during the examination, and the result is recorded on a digital medium. The average cost of the procedure is from 700 to 1700 rubles.

Popular questions and answers

The most popular questions about colposcopy are answered by our experts: PhD, obstetrician-gynecologist, surgeon Sofia Goncharova, PhD, obstetrician-gynecologist Angelina Malsagova and obstetrician-gynecologist, surgeon, ultrasound doctor Dmitry Vladimirov.

How is an extended colposcopy different from a regular colposcopy?

– Extended colposcopy is a more informative diagnostic method. During the procedure, the cervical mucosa is treated with safe chemical compounds: 3% acetic acid solution and Lugol’s solution. Healthy and unhealthy tissues react differently to contact with reagents, which makes it possible to detect pathological foci.

Upon contact with acetic acid, a healthy mucosa becomes lighter, but after a couple of minutes it acquires its normal color. Pathological areas of the epithelium remain light. Normal vessels under the influence of acid narrow and become inconspicuous, atypical ones, in contrast, do not change.

Treatment with Lugol’s solution is an additional diagnostic method. Lugol’s solution contains iodine, which stains healthy epithelial cells in a dark brown color. Pathologically altered epithelium is not stained.

If during the extended procedure the doctor finds pathological areas, the patient is prescribed additional examinations, most often a biopsy.

Will it hurt during a colposcopy?

– In the reviews of patients about colposcopy of the cervix, there is practically no mention of painful sensations. Mild discomfort may occur when the mucosa is treated with Lugol’s solution or acetic acid. Unpleasant sensations pass quickly. As for the biopsy, it is done after treatment of the mucosa with an analgesic spray. Thanks to this, tissue sampling is painless.

Sources of:

  1. New international standards and classifications in colposcopy. Journal “Russian Bulletin of the Obstetrician-Gynecologist” No. 11 for 2011 https://www.mediasphera.ru/issues/rossijskij-vestnik-akushera-ginekologa/2011/6/031726-61222011616
  2. Modern approaches to colposcopic examination. Russian Medical Journal of 09.10.2014 https://www.rmj.ru/articles/ginekologiya/Sovremennye_podhody_k_kolyposkopicheskomu_issledovaniyu/
  3. Colposcopy. Practical guide. Medical news agency. Moscow 2006. https://clck.ru/as5p9

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