How is a colposcopy performed?
Nov 16, 2021
Source: Cainiu Health
Dr. Yan Ying
Introduction
Examination of the vulva and vagina for lesions using colposcopic magnification. A speculum is inserted into the vagina to visualize the cervix, assessing its shape, color, and presence of any abnormalities. During insertion, the speculum must be advanced under direct visualization while gradually expanding the vaginal walls to avoid cervical trauma. A 3% acetic acid test is performed to differentiate between squamous and columnar epithelium on the cervix.
Colposcopy is a commonly used gynecological examination technique that enables visualization of the vagina, cervix, and vulva to detect any pathological changes—most frequently employed in the diagnosis of cervical cancer. So how is colposcopy performed? Below is a detailed explanation.
How Is Colposcopy Performed?
Colposcopy utilizes magnification to examine the vulva and vagina for signs of pathology. A speculum is gently inserted into the vagina under direct visualization while gradually expanding the vaginal canal, taking care to avoid trauma to the cervix. The shape, color, and presence of any abnormalities on the cervix are then carefully assessed. A 3% acetic acid solution is applied to differentiate between squamous and columnar epithelium. During this step, the application must be gentle—avoiding lateral friction—and excessive epithelial shedding, which could interfere with interpretation. An iodine test (Schiller test) is subsequently performed to further confirm the status of the squamous and columnar epithelium. Capillary patterns are meticulously evaluated using a green filter lens on the objective lens, with magnification set at ×20. If suspicious lesions are identified under magnification, targeted biopsies are obtained for histopathological analysis. Finally, the colposcope is removed, the power supply is switched off, and the instrument is returned to its designated storage location. Patients should rest briefly before standing and walking.
Additional Information: Important Considerations Before and After Colposcopy
1. For three days prior to colposcopy, patients should avoid consuming excessively fatty foods and instead opt for easily digestible meals. In general, dietary considerations before any medical examination are essential, as inappropriate food intake may affect test results and hinder accurate clinical assessment.
2. Colposcopy should ideally be scheduled outside of menstruation. The optimal timing is 3–7 days after menstrual bleeding has completely ceased; patients should plan accordingly. Additional preliminary tests—such as vaginal discharge analysis to screen for vaginitis—may be required before proceeding with colposcopy. Furthermore, sexual intercourse and vaginal douching should be avoided for three days prior to the procedure.
3. Adequate rest is essential following colposcopy. As the procedure may cause varying degrees of vaginal trauma—and occasionally result in post-procedural vaginal bleeding—patients should prioritize post-examination self-care. Should anemia develop, dietary interventions or oral iron supplementation may be recommended.
The above outlines the procedure and key considerations for colposcopy. We hope this information is helpful to you.
