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What is colposcopy?

The colposcopy procedure is defined as a simple procedure used to look at the cervix, which is the lower part of the uterus. It is performed to find abnormal cells in the cervix in cervical screening, to detect HPV types such as high-risk type 16, type 18, type 31, type 33, type 35 or 52 in HPV DNA test, or to evaluate some clinical complaints.

Abnormal cells in the cervix; Although it may disappear spontaneously, it can be a precursor of uterine cancer or cervical (cervix) cancer if diagnosis and subsequent treatment is not applied.

This procedure can confirm whether cells found in the cervix are abnormal and is an essential method for diagnosis. It can also determine if you need treatment to remove any abnormal cells present.

The cervix, vagina and vulva; during the procedure, which is a procedure to closely examine for signs of disease or abnormal cells; Your gynecologist uses a special instrument called a colposcope.

If your Pap Smear test result, which every woman should have routinely done, is abnormal, your gynecologist may recommend this procedure. If an unusually abnormal area of ​​cells is found during this procedure, a tissue sample may be taken for laboratory testing (biopsy).

In Which Situations Is Colposcopy Necessary?

Your gynecologist may recommend a colposcopy if abnormalities are revealed on a Pap smear or pelvic exam.

If your Pap smear showed some abnormal cells, or if your DNA and type tests were positive for HPV, colposcopy can help confirm and diagnose potential problems. HPV; It is a virus that can increase your risk for certain types of cancer, including cancers of the uterus, cervix, and vulva. Colposcopy can be used to diagnose the following conditions:

  • Condyloma formation (genital wart) due to HPV types (6,11) (You can review my article on HPV Virus Infection by clicking on the link https://drdermanbasaran.com/hpv-virusu-enfectionu/ .
  • Wound and inflammation in the cervix (cervicitis)
  • Precancerous changes in cervical tissue
  • For diagnosis and diagnosis of CINs
  • For HSIL and LSIL treatment
  • Precancerous changes at the entrance to the vagina
  • For the diagnosis and treatment of VaIN
  • Precancerous changes in the vulva
  • For the diagnosis and treatment of VIN
  • To determine surgical margins during LEEP and Conization

What Are the Risks of Colposcopy?

colposcopy; overall it is a safe procedure with very little risk. It is considered normal to experience bleeding or heavy discharge for a few days after this procedure and to feel pain. In rare cases, complications from biopsies taken during colposcopy may occur.

Colposcopy risks;

  • Experiencing heavy bleeding
  • Infection formation
  • Pelvic pain conditions

Signs and symptoms that may be seen as well as complications;

  • Heavy, intense bleeding during or outside of your menstrual period, different from the normal cycle
  • Shake
  • Fire
  • Severe abdominal pain (including pelvic or groin pain).

After this procedure, you should consult your gynecologist as soon as the symptoms appear.

Things to Consider Before Colposcopy

It is recommended that you stop using vaginal medications, creams, powders or foams 24 to 48 hours before colposcopy. Again, you should avoid having sexual intercourse before colposcopy. You should also stop using tampons or inserting other products into your vagina. 

This process should not be planned during the week of your menstrual period. Before this procedure, you should find out whether you are pregnant or evaluate the possibility of being pregnant with your gynecologist. If you have the procedure, you should ask your doctor if you need to take an over-the-counter pain reliever before the examination. Routine drugs used should also be reported to the gynecologist.

How Is Colposcopy Performed?

Colposcopy is done by a gynecologist and the procedure usually takes 10 to 20 minutes. As during a pelvic exam or Pap smear test, you will be asked to lie on your back on a table with your feet on the support (fork).

Your gynecologist inserts a metal speculum into your vagina. The speculum keeps the walls of your vagina open so that your cervix can be seen clearly.

Your gynecologist will insert the colposcope a few inches from your vulva. He or she will then look at your vagina through the lens of the colposcope by shining a bright light.

The cervix and vagina are wiped with cotton to remove mucus. Your gynecologist may apply a vinegar solution or another type of solution to the area. This solution may cause a burning or tingling sensation. The solution used helps to see the area of ​​suspicious and abnormal cells.

If a suspicious area is seen, your gynecologist will take a small sample of tissue for laboratory testing. This procedure is called a biopsy. Multiple abnormal cells, condyloma, etc. The size of the tissue to be biopsied may also change.

  • Cervical biopsy: A cervical biopsy causes mild discomfort but is usually not painful. You may feel some pressure or cramping during the procedure.
  • Vaginal biopsy: A biopsy  from the lower part of the vagina or vulva may cause pain. For this reason, your gynecologist may apply local anesthesia to numb the area during the procedure.

Colposcopy Results

It is often possible to tell immediately whether there are any abnormal cells in the cervix, vagina or vulva. However, if you have had a biopsy, it may take 4 to 8 weeks to get your results.

If a biopsy taken during the procedure shows you have precancerous tissue, the tissue may need to be removed to prevent cancer from developing. Your gynecologist will apply different removal methods that may be suitable for you.

If the biopsy result shows that cancer is present, you may need to have more tests before starting treatment. Your gynecologist will likely refer you to a gynecological oncologist who specializes in the treatment of gynecological cancer. During any pre-cancerous tissue or cancer treatment, additional colposcopy may be performed to see how well the treatment is progressing and to screen for additional abnormal changes over time.

Your gynecological oncologist will perform the necessary procedures for post-diagnosis treatment and plan the right treatment.

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