If there are obvious signs of pathology of the reproductive system in a woman, one of the first tests is colposcopy of the cervix. It involves a visual assessment of the mucous membrane of the cervical canal, identifying erosions and outgrowths. The advantages of the technique lie in the simplicity and accessibility of its implementation.
Colposcopy - what is it?
When turning to a gynecologist for help, women are often faced with unfamiliar terms and names of examinations. When a colposcopy is prescribed, what kind of procedure it is in gynecology and what its goals are, most patients have no idea. This term usually refers to a procedure in which the examination of the cervix and vagina is carried out using a special device - a colposcope.
It is an optical system mounted on a special tripod. The built-in binocular magnifying glass allows you to magnify the image several times, which makes this method of examination more effective than in a gynecological chair using gynecological mirrors.
Why is colposcopy performed?
The main purpose of the examination is a thorough review of the epithelial tissue of the cervix. Using a colposcope, doctors can evaluate its structure at the microscopic level and identify existing abnormalities. When talking about why colposcopy is performed, it is necessary to highlight the assessment of the effectiveness of the treatment. However, in most cases, colposcopy is indicated when diagnosing the cervix is necessary:
- cervicitis;
- condylomas and warts on the genitals;
- benign and malignant neoplasms (cervical cancer);
- identification of existing lesions;
- targeted biopsy (taking a smear for cytology).
Types of colposcopy
Depending on the conditions and features of the procedure, cervical colposcopy can be of the following types:
- Simple
– involves examining the surface of the uterine cervix and vagina using a colposcope at a magnification of 8–40 times. No medicinal components are used. - Extended colposcopy
is a procedure in which special tests are performed during examination of the cervical epithelium. They involve a doctor monitoring the reaction of the cervical epithelium in response to the use of medications.
What does the procedure visualize?
Examination with a colposcope records any epithelial changes, even small focal ones, finds their location, degree and size of the lesion. During the procedure, the following is assessed:
- drawing of tissue vessels;
- integrity, structure, condition, color of the mucous membrane;
- glands, their shape and presence;
- boundaries and size of epithelial pathological foci.
Staining the epithelium with Lugol's solution in a dark brown color helps to examine the areas of damage in more detail.
Indications for colposcopy
The list of symptoms for which cervical colposcopy may be prescribed is long. The procedure is diagnostic in nature, therefore, to obtain data for making a diagnosis, gynecologists prescribe it for almost any suspected pathology, such as:
- uterine bleeding not associated with menstruation;
- itching and pathological discharge from the vaginal cavity;
- painful sensations with blood during intimate intercourse;
- prolonged nagging pain in the lower abdomen.
In practice, colposcopy of the cervix is prescribed by a gynecologist after an examination in the chair. Detected genital warts and poor results of cytology performed the day before are common indications for colposcopy. In addition, detection of the papilloma virus in the body is also considered an indication for examination (warts may be internal and not detectable in the vaginal cavity).
Indications for the procedure
What is colposcopy in gynecology? This is a very necessary extended diagnostic study, thanks to which it is possible to notice changes in the cervix at an early stage and carry out the necessary procedures to stop the development of the oncological process.
Until recently, it was believed that the most prosperous age for a woman in terms of health is from 28 to 35 years, but recently, due to unfavorable external factors at this age, cases of pathological lesions of the cervix have become more frequent - cervivitis, leukoplakia, ectopia and others - which significantly affect reproductive function. Colposcopy of the cervix allows you to identify diseases at an early stage and develop a treatment strategy.
During the study, the following are revealed:
- precancerous changes in the vagina and cervix;
- cancer;
- erosion and inflammation of the uterine cervix;
- genital warts-condylomas;
- erosion;
- leukoplasia;
- cervical polyps;
- endometriosis;
- ectropion.
Such a study may be conducted during treatment to evaluate the effectiveness of the chosen strategy.
Contraindications to colposcopy
The procedure is non-invasive, so it can be performed almost always. However, there are a number of limitations to this survey. The main one is the period of the menstrual cycle. The main question that women ask is: is it possible to do colposcopy during menstruation? Doctors answer that during this period the study will not be informative, so gynecologists do not conduct it during menstruation. Colposcopy during pregnancy can be performed if indicated. Other contraindications for this examination include:
- the first 2 months after birth;
- 3-4 weeks after curettage, abortion;
- recent cryodestruction, surgery on the uterus;
- allergy to iodine or acetic acid during extended colposcopy of the cervix;
- active inflammatory process in the uterus and pelvic organs.
Colposcopy: consequences
For several days after colposcopy, patients may experience slight reddish or dark (due to colored reagents) discharge. There is no need to worry, this condition is normal, as well as slight tugging sensations in the lower abdomen.
If you have discharge, it is better to use a pad rather than a tampon.
Many patients are concerned about the question of whether it is possible to have sex immediately after colposcopy. Everything is individual here. There are no contraindications for this if the doctor did not take a biopsy test. In this case, it is better to abstain from sexual contact for a week.
In the absence of unpleasant sensations, sex after colposcopy is not prohibited.
If the procedure was performed correctly, complications after colposcopy will not follow. But it is important to monitor your condition the first time after the examination. If the discharge becomes abundant, severe pain is felt in the lower abdomen, or a deterioration in general condition is observed (fever, chills), you should immediately consult a doctor.
When is a colposcopy prescribed?
- If the results of a cytology smear taken during a gynecological examination showed the presence of pathological changes.
- When there are complaints of pulling sensations in the lower abdomen that are not related to menstrual pain
- If there is bleeding after sexual intercourse, repeated more than once.
- When symptoms such as vaginal discharge with an unpleasant odor, itching and rashes on the genitals appear.
- To monitor the ongoing treatment of gynecological diseases.
- When papillomas appear on the cervix and condylomas in the genital area. These neoplasms are a symptom of the human papillomavirus, and in this case colposcopy is mandatory.
- If the gynecologist suspects the development of pathologies occurring in the cervix.
- When diagnosed with cervical erosion.
The last point most often raises the question of whether colposcopy can be performed on pregnant women.
Is colposcopy dangerous during pregnancy?
Colposcopy can be performed during pregnancy if there is a suspicion of cervical erosion.
The fact is that during pregnancy, serious hormonal changes occur in a woman’s body, and erosion can progress. Its widespread distribution is a contraindication for natural childbirth; with this diagnosis, a cesarean section is prescribed.
Upon receipt of a doctor's prescription, a pregnant patient should undergo the procedure. The study is carried out only if there is no threat of miscarriage and if the placenta is located correctly. The doctor leading the pregnancy assesses the risks and necessity of the procedure.
Colposcopy is performed in the early stages of pregnancy.
How to prepare for colposcopy?
To obtain objective research data, it is important to properly prepare the body for the study. Preparing for colposcopy involves following a number of rules, neglect of which will negatively affect the results of the examination. Among the main restrictions:
- Cancellation of all gynecological procedures 48 hours before the examination (douching, baths the day before are prohibited).
- Two days before the procedure, it is forbidden to use means for washing (toilet the external genitalia with warm running water).
- It is prohibited to have sexual intercourse without a condom for 24 hours before the examination.
- On the eve of colposcopy, in consultation with the doctor, it is necessary to discontinue the use of vaginal suppositories, creams, and tablets.
On what day of the cycle should I have a colposcopy?
The timing of the examination is important. Intense cervical discharge does not allow a normal examination of the cervical epithelium for damage or pathological growths. In this regard, colposcopy of the uterus is always carried out in the first days after the end of menstrual flow. In most cases, this is the 6-8th day of the menstrual cycle. Before prescribing a colposcopy, doctors always clarify information about the frequency, regularity of menstruation and the date of the upcoming discharge. This helps you choose the optimal time for the examination.
Tests before colposcopy
Before conducting this examination, doctors always prescribe laboratory tests. A medical examination is aimed at identifying concomitant pathologies, inflammatory processes and infections. At the same time, doctors are in no hurry to do an examination until the necessary analysis has been carried out, since colposcopy in certain cases may be contraindicated. To exclude such a situation, the doctor refers the patient to a number of examinations, including:
- biochemical blood test;
- coagulogram;
- tests for sexually transmitted infections (syphilis, HIV, hepatitis);
- general urine analysis;
- smear from the urethra and vagina.
What should not be done before colposcopy of the cervix?
No special preparation is required for the procedure. However, doctors name a number of restrictions that must be observed before colposcopy. Among them:
- Avoid sexual intercourse on the eve of the procedure (allowed only with the use of a condom).
- Complete avoidance of douching and sitz baths, in which medicinal solutions can penetrate into the vaginal cavity.
- Exclusion from use of special vaginal sprays, creams, ointments, suppositories.
Dysplasia. Strange story. Large iodine-negative area
In fact, it hurts, but everything is tolerable, I felt like I was having my period - my lower abdomen was very tight, the doctor warned me that an hour before the procedure I needed to take any painkiller, for example ketanol. The sensations lasted for about an hour. After 5-6 hours I didn’t feel anything anymore.
I had it done a month ago, so I haven’t recovered yet, but the process is going on, there is no discharge anymore =) In a week I’ll go for a colposcopy, they’ll tell me everything for sure.
As for the scars, perhaps, yes, there is some trauma, they still take a piece of tissue, but my doctor is aware of what we are planning and said that everything will be fine. On the other hand, how can a doctor understand that you don’t have cancer there?
I think she is rushing you, because if you delay after the biopsy, things may get worse, and you will have to do a biopsy again. When performing cryodestruction, the doctor must be sure that there are no cancer cells.
I understand that you don’t want to postpone planning; my husband was also against it. But I said that I don’t want this to turn into cancer, it’s actually scary =(((he agreed with me. Do you feel sorry that you can’t swim? Well, it’s not so scary, the sea won’t escape you = ))) As I understand it, you live next to him. Just sunbathe for a month without swimming. The sooner you do it, the sooner everything will heal, the sooner you can take active action. As they say, “the earlier you get in, the earlier you get out” =)))
How is colposcopy performed?
On the eve of the examination, the gynecologist talks with the woman. He clearly and thoroughly explains to the patient how colposcopy is done and how a woman should behave during the examination. The procedure itself boils down to the following:
- The woman takes off all her clothes below the waist and sits down in the gynecological chair.
- The doctor carefully inserts a speculum into the vagina and guides the colposcope.
- Using a binocular, the doctor carefully examines the cervical canal and vaginal cavity.
- All recorded changes are reflected in a special research protocol.
Many people are convinced that colposcopy is painful, but in practice women experience only mild discomfort. The duration of the study does not exceed 30 minutes. If necessary, the doctor may decide to further conduct an extended study. The method involves sampling. To do this, use a 3% solution of acetic acid or Lugol (iodine solution). Upon completion, a conclusion is issued describing the recorded changes and deviations.
What are the contraindications
Colposcopy has no absolute contraindications. This is explained by the simplicity and harmlessness of procedural actions. However, such an event is not carried out during menstrual flow. It is necessary to wait until they stop completely.
This examination is not performed during menstruation.
Women can undergo colposcopy without fear while pregnant. Patients suffering from intolerance to acetic acid, sensitive to iodine preparations and other components used in the study should be treated with caution.
Interpretation of colposcopy
Only a doctor can correctly evaluate the results of colposcopy. In the conclusion, various parameters are indicated, depending on the type of changes detected. Among the commonly diagnosed pathologies:
- Ectopia
is the exit of columnar epithelial cells beyond the boundaries of the uterine cervix. - Metaplasia
is the detection of immature cells in the metaplastic epithelium. - Leukoplakia
is keratinized cells of stratified epithelium that look like a white spot on the cervix. Indicates deep cell damage.
379229 colleagues are waiting for you at MirVracha.
Today is the first case from the Fomin Clinic. Nothing outstanding, but my diagnostic and treatment capabilities have become much more impressive, and the case is not bad. The patient is 42 years old, she was seen in my ATE clinic, the last visit was in December 2020. Screening for cervical cancer December 2020 - Papanicolaou grade 1 ( normal), HPV + (but 16/18 types have not been identified) It is recommended to repeat the study in a year Appearance for an appointment in December 2020 at the Fomina Clinic Screening for cervical cancer - H-SIL (CIN II), HPV 35 General period of persistence of HPV 11 years, but it is unknown whether the type of virus has changed. The patient, of course, is in shock. But there is no need to be shocked - this is exactly that phase. when the diagnosis is made on time and the manipulations are justified Extended colposcopy - the first photos from my new friend Hans - who is Leisegang - Bentley in the world of colposcopes
Overview shot - nothing special
Test with vinegar On the front lip we can clearly see the border between the cylindrical and stratified squamous epithelium, there are open and closed glands, there are no problems. Along the posterior lip there is a clear aceto-white epithelium, which plunges into the cervical canal
Let's take a closer look. For me, it's quite tender. The second good news is a very neat small damage, it will be easy to remove. We believe that this is a type 2 transformation zone, an abnormal colposcopic picture 1
Schiller's test is annoying - it's a bit bright. Let me remind you - we are always looking for areas “whiter than white” and “yellower than yellow”
I do conization with the same famous Surgitron. It turns out clean and neat. Why conization? I want to take it deeper, because a severe lesion can be hidden in the canal. Now the world of hematoxylin and eosin is a histological conclusion. We are now working with a completely space laboratory. Everything is digitalized, each case is assessed by several pathologists. Making histological reports is a dream. Upon request, you can access the complete archive of microphotographs of the patient. She underwent surgery on the evening of February 1, and received the result on the evening of February 5
Check out the beauty of the description
Further in the protocol there is a detailed description with markings of all glasses and blocks. Everything was completed on time, neither earlier nor later.
Now it’s just observation and control. And with a simple examination in the mirrors, it all looks like “oh, what a neck!” Come, dear ladies, for cervical screening. Don't get sick https://medgyna.livejournal.com/292887.html
