Cervical Colposcopy is a procedure that needs to be done if you’ve had certain abnormal Pap smears. If you’ve had a Pap smear that was read as anything other than normal or ASCUS w/ negative HPV, you probably need a colposcopy. Its purpose is to localize the area where abnormal cells came from on your cervix. Pap smear is a screening test to just tell us if there are any cellular abnormalities (hint pre-cancerous lesions) on your cervix. If screening test comes back abnormal, THEN we need to localize it and manage it; and that’s done with colposcopy. Using certain cellular characteristics of vaginal and cervical epithelia (glycogen content to be specific), we use two different dyes to check for abnormal discoloration of the cervical epithelia. Once the area of concern is localized then we use a green light filter to check for other features of the abnormality such as punctation or mosaicism and then perform biopsies of the sites. Because some of those changes can extend into the cervical canal, typically Endocervical Curettage (ECC) is performed as well to make sure nothing is amiss. I feel It is important to convey how much this field has evolved in the past 20 years thanks to technology. We can now use a single swab to perform a pap smear, check for gonorrhea, chlamydia, trichomonas, Human Papilloma Virus, etc. We have also learned that over 99% of abnormal cervical pathology and cancer is related to infection with high risk class of HPV (and not just cervical CA, high risk HPV has now been connected to Mouth, tongue and throat ca, as well as vaginal, vulvar, rectal and anal cancer as well, soooooooo, unless you’re older than 45 y/o you may want to consider getting your HPV Vaccine such as GARDASIL9).

How is the procedure performed: Very similar to when you had your pap done, a speculum is inserted into your vagina and cervix cleansed, dyes applied, green filter used, and the biopsies done. You may feel a pinch from the biopsies but generally you don’t need any pain meds. Occasionally, there’s some bleeding which will be stopped by applying pressure or chemicals, that may lead to a foul odor a day or two after your procedure which should resolve spontaneously. We recommend no sex for at least 72 hours post procedure to reduce chance of biopsy site bleeding. We do bring our patients back in 2-3 weeks to review the result and go over long-term management and when the patient needs to come back again.

https://www.gardasil9.com/

https://www.mayoclinic.org/tests-procedures/colposcopy/about/pac-20385036

https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/colposcopy

https://www.cancer.gov/about-cancer/causes-prevention/risk/infectious-agents/hpv-and-cancer

https://www.mayoclinic.org/diseases-conditions/cervical-cancer/symptoms-causes/syc-20352501

https://www.who.int/news-room/fact-sheets/detail/human-papilloma-virus-and-cancer

https://www.cdc.gov/cancer/hpv/index.htm

https://blogs.cdc.gov/cancer/2018/01/09/3-myths-about-cervical-cancer-screening/

https://www.cdc.gov/cancer/cervical/basic_info/screening.htm

https://www.cdc.gov/vaccines/vpd/hpv/hcp/recommendations.html