Colposcopy: What to Expect
First Things First
Alright, breathe. You are getting a colposcopy. This is not the end of the world. This does NOT mean that you have cervical cancer. This doesn't even necessarily mean that there is anything wrong. Chances are if you are getting a colposcopy you had a pap test that came back abnormal. So, what exactly is a colposcopy?
Plainly put a colposcopy, pronounced 'kol-pos-kuh-pee', is a procedure that allows the doctor to get a closer look at the vulva, vagina, and cervix. The doctor will use a colposcope, a lighted magnifying device often with a camera and computer attached, to examine the cervix. Your doctor might choose to repeat the pap test at this time. If any problem areas are seen your doctor might decided to take a biopsy of that area. If need be your doctor might also decide to take a sample from the cervical canal, called an endocervical curettage.
That's it. That's all. You will need to do certain things to prepare for the procedure. You will also need to follow a set of instructions after the procedure to insure proper healing.
Before the Procedure
Chances are you got a phone call from your doctors office about a week after your last pap test saying that there were some abnormalities and that you should get a colposcopy. At this point the first thing that is probably going through your mind is 'cervical cancer'. Calm down. Take a moment and breathe. There are a lot of reasons a pap test can come back abnormal and they don't all mean cancer. Viral, fungal, bacterial, or protozoan infections can all lead to an abnormal pap test.
Your doctor's office will give you a set of instructions, either by phone or by mail, for you to follow to get you ready for the procedure.
- You cannot have a colposcopy performed while you are on your period. There are some doctors that recommend getting the procedure done in the first week after your period.
- You cannot put anything into the vagina for a few days before the procedure. This means no tampons, no douching, and no vagina medications.
- You cannot have sexual intercourse a few days before your period. (though this should go without saying)
The Day of the Procedure
Your doctor will order a pregnancy test to be done before you have your colposcopy. It is safe to do a colposcopy during pregnancy, and if need be a biopsy can be done. However, it is not safe to do an endocervial curettage while pregnant. This test is most often in the form of a urine test and can be done an hour or two before the procedure.
After the pregnancy test it is recommend to take a pain reliever, like advil or motrin. This will help to alleviate some of the discomfort often found during the procedure. If you did not have to do a urine test before your scheduled procedure then you will want to take the time to empty your bladder now.
I would recommend wearing comfortable clothing the day of your procedure. You might be in some discomfort after the procedure and tight fitting clothes may aggravate you further.
Unless you are immune to pain you will experience a sharp pain when the biopsy is performed. If you are not good with pain, or simply don't want to experience it you can ask your doctor for a general anesthetic. It is important to note that not all doctors will use one unless you ask for it.
The colposcopy itself is mildly uncomfortable, but should not be painful. If you experience anything abnormally painful let your doctor know immediately.
You will have to disrobe from the waist down. You will be given a blanket to cover yourself. The test will be completed while you are on your back with your feet in the stirrups.
Your doctor will first use a speculum to examine the vagina and cervix. The speculum will hold the vagina open so that the colposcope can be used. Once the doctor has visually examined the cervix a pap smear will be performed. After the pap smear your doctor will use a cotton swab to apply acetic acid, vinegar, to the cervix. The acetic acid helps your doctor to see the areas of abnormalities since they will turn white in the presences of acetic acid. Once your doctor has identified any areas of abnormal activity a biopsy will be performed.
Some doctors will use a topical anesthetic to reduce the pain associated with the biopsy, especially if more than one biopsy is being performed. Often an endocervical curettage is performed. Often the tool used to collect the samples for this procedure looks like a a small pipe cleaner.
After all of the samples are taken your doctor will use Monsel's liquid or silver nitrate to stop the bleeding. Once the bleeding has stopped your doctor will remove the speculum and the procedure is over. In all the colposcopy typically takes less than thirty minutes.
After the Procedure
You should bring a pad with you to the procedure, though most doctors will provide you with one. It is not uncommon to experience light bleeding or spotting for a few hours after the procedure. Your doctor will let you know about the typical side effects of the procedure: yellowish/brown discharge, more discharge than normal, and light bleeding. It is also not uncommon to experience cramping or slight dull pain after the procedure, especially after a biopsy is done.
However, after doing some research online after experiencing additional side effect I found that not all doctors will warn you of all the common after effects. it is not uncommon for, a few days after the procedure, to pass a tissue like clump of discharge that may have a little dried blood. Typically this is only done once, anything further and you should consult your doctor. Basically what is happening is your cervix is sloughing off scabs and damaged cells in order to heal. If you are not expecting it, it can cause alarm. If you are ever concerned about anything do not hesitate in calling your doctor.
It is recommended that you do not place anything into the vagina for up to a week after the procedure. This will give your cervix the time it needs to heal.
When to Call Your Doctor
Sometimes after you have a procedure for the first time it can be hard to determine if you need to call your doctor or not. After all how are you supposed to know what is normal and what is not? All of the above listed experiences are normal. Call your doctor if you experience any:
- heavy bleeding (more than that of a menstrual period)
- belly pain
- bad-smelling discharge
You should get the results from the pap and any biopsies in at least two weeks. Hopefully they will come back normal. However, if the results do indicate that action needs to be taken your doctor will provide you with the needed information and decide the course of action. You might need additional testing or you might need to have some of the abnormal areas removed.