Colposcopy

Colposcopy is a diagnostic procedure that allows detailed examination of the cervix, vagina, and vulva using a special optical instrument called a colposcope. The colposcope magnifies the image 10–40 times, enabling the physician to detect changes that are not visible to the naked eye, such as atypical cells, inflammatory changes, or precancerous conditions. The procedure is commonly performed after abnormal results of a Pap test (cervical cytology).

Indications for colposcopy

1. Abnormal Pap test results. If atypical cells, dysplasia, or other pathological changes are detected on a Pap smear, colposcopy helps clarify the diagnosis.
2. Suspicion of precancerous lesions or cervical cancer. Colposcopy allows identification of cervical tissue changes that may be associated with human papillomavirus (HPV) infection or precancerous conditions.
3. Follow-up after treatment. Colposcopy is used to assess the cervix after treatment of precancerous lesions or to monitor chronic infections.
4. Postcoital bleeding. Colposcopy may help determine the cause of bleeding occurring after sexual intercourse.
5. Suspected inflammatory or infectious diseases. The procedure allows visualization of inflammatory changes in the cervix or vaginal tissues.

How colposcopy is performed in Belarus

Colposcopy is a non-invasive, outpatient procedure that usually takes about 10–20 minutes.

Main steps of the procedure:

1. Preparation. The patient is positioned on a gynecological examination chair. A vaginal speculum is inserted to allow access to the cervix.
2. Examination with a colposcope. The colposcope, equipped with optical magnification and illumination, is positioned at a short distance from the vaginal opening and does not come into contact with the patient.
3. Application of diagnostic solutions. To improve visualization and identify abnormal epithelium, solutions such as acetic acid or iodine may be applied to the cervix. These agents help highlight abnormal tissue areas.
4. Biopsy (if necessary). If suspicious areas are detected, a small tissue sample may be taken for histological examination. Biopsy is performed only when abnormal findings are present.
5. Completion of the procedure. After examination and, if needed, biopsy, the procedure is completed, and the patient may resume normal activities immediately.

Preparation for colposcopy

To ensure accurate results, the following recommendations should be followed:

• Avoid sexual intercourse for 1–2 days before the procedure.
• Do not use vaginal creams, suppositories, or tampons for 2 days prior to the examination.
• Avoid vaginal douching before the procedure.
• Colposcopy should not be performed during menstruation, as blood may interfere with visualization.

Colposcopy results

The results depend on the findings observed during the examination:

1. Normal findings. If no abnormalities are detected, the cervix and surrounding tissues appear healthy, and no additional treatment is required. A repeat Pap test may be recommended after several years.
2. Abnormal findings. If suspicious changes are observed (such as atypical cells, dysplasia, inflammation, or suspected malignancy), a biopsy may be performed for further evaluation.

Biopsy during colposcopy

If pathological changes are identified, a biopsy may be taken for histological analysis. This helps confirm the diagnosis and determine further management. Biopsy samples may be obtained from one or multiple areas of the cervix or vagina.

After biopsy, mild bleeding or discomfort may occur and usually resolves within a few days.

Advantages of colposcopy

• Early detection of disease: colposcopy enables identification of precancerous lesions and early-stage cervical cancer.
• Minimal invasiveness: the procedure is performed on an outpatient basis without significant intervention.
• High diagnostic accuracy: magnified visualization allows detection of even subtle tissue changes.

Colposcopy is a safe and effective diagnostic method that helps identify precancerous conditions, inflammatory changes, and infections of the cervix and vagina. Regular examinations and timely diagnosis play a key role in preventing serious disease and preserving women’s reproductive health.