Colposcopy: What to Expect

For many women, abnormal pap smear results can be scary and stressful enough without having to wonder about the next step in diagnosing the abnormal pap results. In most cases, your gynecologist will want to perform a colposcopy to more closely examine the cervix for abnormal cells. During the procedure, the doctor will insert a speculum into the vagina, just like he would for a regular exam. The doctor will examine your cervix with an instrument called a colposcope, which is basically a large microscope used for magnifying the doctor's view of the cervix.

A vinegar solution is swabbed inside the cervix for the exam. This solution will cause abnormal areas on the surface of the cervix to appear white. If any of these abnormal areas appear, the doctor will perform a biopsy of the area: he will cut a small portion of the area and send it to a lab to be tested for abnormalities. After the colposcopy and biopsies are complete, another solution will be applied to the cervix to stop any bleeding from biopsied areas. As the cervix sheds this over the next few days, you may have a discharge that looks like coffee grounds. The colposcopy procedure itself is more uncomfortable than it is painful. You will experience some cramping during the procedure, and possibly after. Ibuprofen (Advil, Motrin) should take care of the cramping. Your doctor will likely also advise you not to use tampons or engage in sexual intercourse for 3-4 weeks after the procedure.

The presence of abnormal cell changes is called "dysplasia." The lab will diagnose the abnormal cells/dysplasia based on severity. Abnormal cells on the surface of the cervix are classified in different ways. Minor changes are simply classified as Atypical Squamous Cells (ASC). Mild, moderate, and sever dysplasia are classified as squamous intraepithelial lesions. Mild dysplasia that is unlikely to progress to cancer is referred to as low-grade squamous intraepithelial lesions (LSIL). Moderate to severe dysplasia is called high-grade cervical intraepithelial neoplasia (HSIL). Within these two categories, precancerous cells on the surface of the cervix are categorized into three levels, CIN 1-3, based on what portion of the layer of cells is affected. Depending on the severity of the dysplasia and the affected area, your doctor will decide what further treatment is necessary.