Colposcopy of the cervix - what is it and why is it prescribed. Colposcopy - diagnostic examination of the cervix Examination of the cervix under a microscope

The date: 21.10.2019

- this is one of modern methods examination of the vulva, vagina, cervix. Their condition is determined by the color of the tissue, the vascular pattern, its relief, the shape of the glands, and the localization of abnormal areas. AT necessary cases(precancerous conditions of the uterus, polyps, etc.) the procedure allows you to perform a targeted biopsy of the endometrium.

A colposcope is used to perform a colposcopy. This binocular microscope on movable stands is equipped with optics, a special source of cold light with the possibility of its regulation, which makes it possible to illuminate the examined surface well. The kit also includes color filters (green or blue), which allows you to enhance the contrast of the image, and to study the vessels and epithelial formations in more detail. There are photo and video colposcopes that allow you to print photos or record video and already on the screen at even greater magnification, thoroughly examine the picture and keep a chronology of the dynamics of observations for comparison with previous results.

Types of colposcopy

A simple study is carried out only visually, without the use of medications. With this method, the type of discharge is analyzed (smell, white, purulent, bloody, etc.), the shape and size of the cervix, its ectocervix, vascular pattern, the presence of scars, tumors, ruptures, the boundary of the transformation zone (ZT) of the squamous epithelium into a cylindrical one is determined.

An extended colposcopy is performed using various reagents:

3% acetic acid(acetic acid test) - under its influence, normal vessels narrow, and pathologically altered ones do not show such a reaction;
Lugol's solution(Schiller's test - a healthy squamous epithelium becomes brown in color. In the presence of an iodine-negative zone (unstained), a targeted biopsy is necessary;
Solution of iodine and potassium(Shiller-Pisarev test) - as in the case of using Lugol's solution, the susceptibility of tissues to staining is determined. In this case, the iodine number of the depth of inflammation is calculated in points;
Fluorochromes- the epithelium is processed by these substances and is considered under ultraviolet rays. Cancer cells luminesce pink;
Chrobak test- use of a thin probe. If, when they press on a suspicious area, bleeding of the tissue begins, then this indicates the presence of neoplasia;
Hormonal test(with adrenaline) and chromotests are less common.

Indications for colposcopy

Normally, every woman should undergo this procedure at least once a year. After all, many diseases are asymptomatic. The doctor prescribes this diagnosis in the following cases:

erosion was revealed at the gynecological appointment;
have unusual vaginal discharge;
change menstrual cycle;
the appearance of pulling pains in the lower abdomen;
uterine bleeding;
"bad" result of a cytological smear;
pain during sex;
the presence of inflammation in the cervix;
genital warts;
suspicion of precancerous conditions (leukoplakia, polyps, etc.);
to choose a treatment program;
to monitor the effectiveness of the course of therapy.

Contraindications for colposcopy

first 2 months postpartum period;
1 month after abortion;
individual intolerance to reagents (iodine, acetic acid);
30-60 days after surgical operation on the uterus.

Preparation for colposcopy

On the eve of the examination, the following simple rules must be followed to preserve the natural microflora of the vagina:

no sex for at least 2 days;
douching is prohibited;
do not use vaginal suppositories, ointments, tampons;
during menstruation, the procedure is not carried out.

On what day of the cycle do colposcopy

The optimal period for diagnosis is 5, 6 and 7 days of the cycle (1-3 days after the end of bleeding). In certain situations, it is also carried out on other days, although it will be less informative due to the increased production of mucus on the cervix during this period.

Do colposcopy in the clinic

Yes, this procedure is carried out on an outpatient basis in a regular clinic or private hospital.

How is a colposcopy performed?

The duration of the study is approximately half an hour. The patient in the lithotomy position is located on the gynecological chair. At a distance of 15-20 cm from the genitals (not inserted inside), a colposcope is located. The woman's vagina is expanded with a speculum. The doctor removes mucus with a cotton swab and treats the mucous membrane of the vagina and cervix with a 3 percent acetic acid. After about a minute, local edema of the squamous epithelium occurs. A powerful increase (up to 40 times) of the colposcope magnifier allows you to see in detail the studied areas of the mucosa. Healthy vessels (in the form of bushes, brushes different size, smoothly branching) while narrowing. Damaged vessels (short, with a sharp gradation, in the form of a corkscrew, commas, hooks) do not show such a reaction. Even minor changes in the squamous epithelium are expressed as whitish spots. The longer the fabric remains white, the deeper its damage. At the same time, HPV infections are detected in 90% of cases.

After that, treatment is done with a solution of iodine or Lugol (Schiller's test). Healthy areas of glycogen-rich squamous epithelium stain in Brown color, anomalous (with low content glycogen) - in the form of light spots. This phenomenon is typical for dysplasia, atrophy, leukoplakia. In such cases, a biopsy is taken. This is the pinching off of a small piece of suspicious tissue for later examination under a microscope. Anesthesia is not required for this procedure.

If a fluorescent colposcopy of the cervix is performed, then fluorochromes are applied to the endocervix and then examined under ultraviolet light. Cancer cells glow pinkish.

With chromocolposcopy, the mucosa is treated with dyes (for example, methylene blue). The degree of tissue staining allows you to differentiate between healthy and pathological areas.

What can be seen on a colposcopy

Colposcopy can diagnose early dates such gynecological diseases as leukoplakia, carcinoma, endometriosis, metaplasia, warts, dysplasia, mucosal erosion, cervecitis, polyps, to prevent the development of the disease and its transition to neighboring organs. All these pathologies have their own colposcopic picture.

Is it possible to do a colposcopy during pregnancy

Before planning a pregnancy, it is important to do a colposcopy to exclude abnormal changes in the mucosa and the associated early stages of disease. This will allow you to assess the risks for the woman and the unborn baby.

It often happens that pregnancy comes as a surprise to a woman. And when future mommy begins a routine examination, and then all sorts of surprises come out in the form of pathological processes in the cervix. Colposcopy during pregnancy is necessary if the doctor suspects erosion, polyps and other pathologies in the patient. After all, during pregnancy, immunity decreases, a change in hormonal status can provoke progress in development. an existing disease. During pregnancy, this study is carried out without the use of chemicals, so it is safe for the fetus and the woman herself. If any abnormalities in the mucosa are detected, then treatment is planned after childbirth due to the risk of bleeding. A biopsy is prescribed only in extreme cases (for example, with grade 3 cervical dysplasia or the presence of cancerous tumor). In the event of a poor prognosis, delivery to the woman in labor is carried out by caesarean section.

Colposcopy is also mandatory before in vitro fertilization to assess the possibility of normal attachment. gestational sac in the uterus, as well as pregnancy and natural childbirth. If pathologies of the lining layer of the cervix are detected, IVF is pointless. Such a woman is not allowed on the protocol.

What are the consequences after a colposcopy?

If a simple colposcopy was performed, without the use of tests and taking a biopsy, then after the procedure there are no restrictions on the woman's lifestyle.

After an extended procedure, dark brown vaginal discharge due to iodine or Lugol's solution is possible (normally 2-3 days). Within 1-2 days, in rare cases, spotting bleeding is possible.

In the case of taking a biopsy, you should refrain from sexual intercourse for about a week, exclude thermal procedures on the uterine area (bath, sauna, hammam), do not engage in hard work and sports, do not use tampons and douching. At profuse bleeding, chills, pain in the lower abdomen, fever, you should consult a doctor.

Colposcopy results

According to this screening, the gynecologist concludes that there is no or presence of pathology of the vaginal epithelium and cervical mucosa. The conclusion of the doctor can be presented in the form of a diagram, in writing in words or colpophoto.

The study of a biopsy of the mucous membrane of the cervix lasts approximately 10-14 days. The reliability of the analysis is high and amounts to 90%.

The simple colposcopy protocol describes the following indicators:

Parameters of the cervix (shape, size, color of the lining epithelium);
The state of the external pharynx, its hyperemia;
Whether or not there are discharges, what they are (bloody, purulent, etc.);
Vascular drawing.
Presence/absence of such pathologies as ulcers, warts, keratosis, polyps, erosions, atrophy.

When carrying out an extended procedure, the following results are additionally noted:

Reaction time after application of acetic acid;
Localization of the transformation zone, its type;
Type and shades of staining of the epithelium when applying Lugol's solution;
The presence or absence of an iodine-negative reaction, the area of the altered areas;
Establishing the nature of mosaic, punctuation, vascular pattern;
Do I need a biopsy, diagnostic curettage.

There are many classifications and systems for interpreting the results of colposcopy: Reid's colposcopic index in points (0-2 points - minor damage, 3-5 - moderate severity, 6-8 - high degree of damage), Bauer, Bush classification, Coppleson- Pixley).

The normal colposcopic picture corresponds to:

The epithelium is stratified squamous, its surface is even and smooth, painted in pink color(may be purple during pregnancy and before menstruation);
Sample 3% acetic acid - positive;
Schiller's test - the mucosa is uniformly colored brown;
Cylindrical epithelium within the endocervix;
The transformation zone is located on the border of the squamous and columnar epithelium.

Identifiers of pathological changes in the mucosa are:

Acetowhite epithelium;
Iodine-negative zones (punctuation) not stained with Lugol's solution;
Mosaic pattern of the mucosa (sometimes marbled and rough);
The presence of leukoplakia (films or plaques white color);
Formation of pathological vessels;
Negative test with 3% acetic acid (there are atypical capillaries in the epithelium);
The transformation zone is atypical;
There are mixed signs of cervical pathology such as warts, inflammatory changes in the epithelium, atrophy, endometriosis or polyps.

To exclude the presence of diseases transmitted through sexual contact, the doctor prescribes tests PCR method. After the treatment (if there were infections), a second colposcopy is performed. If atypical cells remain, then this indicates the development of a precancerous condition.

Colposcopy results are influenced by:

Pregnancy;
Lack of hormones of the estrogen and progesterone group;
Reception hormonal contraceptives;
Phase of the menstrual cycle: proliferative, ovulatory, luteal);
The degree of the inflammatory process;
Age criterion ( reproductive period, menopause);
Doctor's professionalism.

Colposcopy itself is quite subjective. An important role is played by how to interpret its results, and what classification to use. Therefore, the pathology found during the study should be confirmed by cytological and histological analyzes. The human factor cannot be ruled out. In case of doubt about the competence of the doctor or the results of the analysis, it is better to conduct a diagnosis in several medical institutions and laboratories.

To save women's health it is important not only to healthy lifestyle life and leave bad habits but also to be regularly examined by a gynecologist. Colposcopy should be a mandatory examination of both patients registered in the antenatal clinic with cervical pathology, and all women who have crossed the 30-year age limit.

Colposcopy is a method of examining the genitals of a woman using a special device - a colposcope. To obtain the maximum amount of information about the state of the genital organs, preparation for colposcopy and additional tests are necessary stages of the study.

A special optical device is used for colposcopy.

According to the indications, the doctor may prescribe a classic examination method using a colposcope or an extended one. The latter gives more information and allows you to conduct a series of tests to assess the condition of the mucosa.

Colposcopy in gynecology helps to diagnose the most various pathologies. It is prescribed for suspicion of the following types of ailments:

genital warts;
oncology of the cervix, vulva, vagina;
precancerous changes in the tissues of the reproductive system.

During the diagnosis, a specialist can take tissue for a biopsy, as well as see the ongoing changes in the epithelium of the lower part of the uterus, determine the nature of the lesion, the localization of the pathology. The use of a colposcope helps to diagnose the most various diseases. After identifying the disease, the doctor can choose a treatment regimen.

A pregnant patient may be referred for a colposcopy. This is done to examine the cervix, to exclude invasive pathologies and the possible development of cervical cancer and other neoplasms. This procedure should be carried out by every woman before conceiving a child. However, few people plan pregnancy. To make sure that the woman is healthy, the doctor prescribes a study for her. Many people wonder if it is possible to do a colposcopy during pregnancy. Yes, this procedure is performed on women, but without diagnostic tests. It has no effect on the child.

How to prepare for the procedure?

Colposcopy is not performed during menstruation.

There is no special preparation before a colposcopy. However, the examination is postponed if the patient is menstruating. Not suitable for colposcopy in the middle of the menstrual cycle, as during this period a lot of mucus accumulates in the cervix.

The best time for an examination is on the eve of menstruation or a couple of days after them.

Preparation for the procedure is simple and consists of the following:

two days before the examination, you should refrain from intimacy;
you can not use tampons a day before the date of diagnosis;
douching is not allowed.

On the day of the procedure, you must come to the doctor, taking a pad with you. If you are afraid of infection, take a diaper with you, which you can lay on a chair.

The course of the procedure

Colposcopy is carried out in the same way as other gynecological examinations on the chair. In this case, a special mirror is inserted into the vagina, which exposes the cervix. Then a colposcope is moved to the vulva, allowing you to examine in detail the walls of the genital organs. This procedure takes no more than ten minutes. If pathological areas are found, the doctor may take pieces of tissue for a biopsy.

Colposcopy for virgins is carried out in the same way as for other women. However, it is not shown to every virgin. It is not carried out for those girls whose hymen has a continuous shape. If the gynecologist sees a hymen of such a shape that it will be possible to conduct an examination with the help of a small mirror, then the girl may be prescribed an examination. In other cases, the gynecologist informs the patient about the difficulty of examination due to the hymen.

According to the indications, the doctor can perform a simple colposcopy with an examination of the genital mucosa. To do it, anesthesia is not needed. During the examination, the doctor can get quite extensive information about the condition of the walls of the vagina, the initial section of the uterus, and the cervix. He sees the color of the mucosa, its surface, the boundaries of the tissues, the presence of gaps. During the examination, he can take tissue for a biopsy, as well as examine the discharge.

Sometimes a patient needs an advanced colposcopy. It involves examining the condition of the genital mucosa after treatment with three percent acetic acid. As a result of exposure to a chemical, staining of the mucosa appears. This leads to a clear manifestation of all existing pathologies on the surface of the neck.

The next stage of the inspection is the treatment of the surface to be inspected with Lugol's solution. It helps to determine if there are precancerous cell changes. Based on the results of the examination, the doctor takes tissue for a biopsy.

Colposcopy results on monitor

Sometimes a doctor may prescribe a procedure for patients with candidiasis. However, this should only be done in case of a fungal infection in emergency cases, and usually a woman is not examined colposcopically for thrush. You must first treat the disease.

After diagnosis

A woman should know not only how to prepare for a colposcopy, but also what to do after it.

If the study did not take tissue for biopsy, then sexual life can be restored on the day of the procedure. Sometimes there may be some bleeding after diagnosis. It usually lasts no more than three days. In this case, the woman should refrain from sexual intercourse, douching and taking medication until the bleeding stops.

Many people ask what to do if, after the examination, the bleeding does not stop for more than three days. In this case, you must urgently see a doctor.

Contraindications

Extended colposcopy is not performed for patients with intolerance to acetic acid and iodine

There are no serious contraindications to the study. It is prescribed for pregnant women, in the first eight weeks after childbirth, after surgical interventions on the genitals. However, diagnostics cannot be done for people suffering from vinegar intolerance. It is also worth telling the doctor about the menstrual cycle so that the diagnosis does not fall on the period of menstruation.

Diagnosis of pathologies of the reproductive system is a quick procedure that allows you to accurately determine the pathology, see its location, degree of damage and decide which method of treatment should be carried out.

In diseases of the cervix, as a rule, there are no painful symptoms and obvious signs of pathology. It is possible to guess about their existence by indirect signs, for example, the appearance of blood impurities in the secretions. Some of the diseases are considered precancerous, as there is a possibility of mutation of the cells of the damaged tissues of the uterus. The use of colposcopy allows you to carefully examine the surface of areas inaccessible to conventional gynecological examination.

Content:

What is colposcopy

This is one of the methods of diagnosing gynecological diseases. It is usually used if, during a routine examination, pathological areas are found on the surface of the mucous membranes of the vagina or cervical canal of the uterus. Colposcopy is also performed when a cytological examination of a smear shows the presence of cells of an atypical structure.

The procedure is prescribed if the patient has complaints about pain or itching in the vagina, unusual bloody issues, including after intercourse, constant pulling pains in the lower abdomen. Colposcopy of the vagina and cervix reveals structural changes in tissues at the earliest stages, when a complete cure is possible.

A colposcope is a device with which you can examine the vaginal part of the uterine canal under illumination and an optical magnification of 2-40 times. Sometimes this makes it possible to diagnose the onset of the disease even earlier than characteristic changes in the smear appear. If necessary, a biopsy of the cervix is \u200b\u200bsimultaneously performedif there is doubt about the nature of the pathology.

With the help of colposcopy, diseases such as erosion, leukoplakia, dysplasia of the squamous epithelium of the pharynx of the cervix, papillomatosis, cervicitis (inflammation of the mucous membranes of the cervix), endometriosis, and cancerous tumors of the vagina and uterus can be diagnosed. This diagnostic method is indispensable in assessing the results of treatment of diseases of the cervix.

Video: Purpose and benefits of colposcopy

When the procedure cannot be performed

Colposcopy has no contraindications, as the procedure is completely safe. This method examines both young and elderly women. However, there are situations when a colposcopic examination is not performed.

So, during menstruation, the examination is useless. After childbirth, colposcopy is performed no earlier than 2 months later, so as not to injure unhealed tissues. Examination should not be done in the presence of purulent inflammatory processes, as well as with atrophy of the mucous membranes.

How is a colposcopy performed?

The procedure, as a rule, is carried out on the 5-7th day of the menstrual cycle, when the so-called "dry" period is observed (the discharge is the most meager).

Preparation for colposcopy

Preparation for colposcopy is to follow certain recommendations.

The woman is warned that a week before the examination, it is necessary to stop carrying out any procedures related to the use of vaginal suppositories and ointments. You must abstain from sexual intercourse for 2 days before the colposcopy. On the eve of the examination, douching, using tampons, and taking baths should not be done, as this will disrupt the natural composition of the microflora.

During the procedure, some reagents are used (for example, iodine compounds). The doctor finds out in advance whether there is an allergy to such substances or any medications.

The procedure is virtually painless and may cause only mild discomfort. The colposcope is located outside, and there is no direct contact with the surface of the vagina. For examination, conventional vaginal mirrors are used. The procedure lasts no more than half an hour. However, if a woman is particularly sensitive, then she can take an anesthetic tablet (paracetamol or ibuprofen) in advance.

Colposcopy and its types

During the examination, the condition of the mucous membranes is assessed, the size of the damaged areas is established, and a preliminary conclusion is made about the benign or malignant nature of the disease. In case of suspicion of cancer, a sample of damaged tissue is taken for a more detailed study of its cells.

There are 2 types of cervical colposcopy.

Simple colposcopy. During this procedure, the surface is inspected under uniform strong illumination. This allows you to visually assess the condition of the mucous membrane and its vessels.

Extended colposcopy. The method is applied if necessary. exact definition sizes and boundaries of pathological areas.

The procedure is carried out in the following sequence:

The colposcope is located a few centimeters from the vagina. After turning on the lighting device, the surface of the cervix of the uterus is treated with a 3% solution of acetic acid. At the same time, in healthy tissues, the vessels narrow, while in pathological ones they remain unchanged.
Then the cervix is treated with Lugol's solution (iodine). Healthy tissues take on a dark brown hue, while areas with damaged cells remain pink.
By changing the magnification, the doctor studies the nature of the damage, determines the boundaries of the pathological area.
A swab is taken from the vagina and cervix.
If suspicious tumors are found, a biopsy is performed.

During the examination, the image is displayed on the monitor screen. Varieties of extended research are also color and fluorescent colposcopy.

When performing a colposcopy using an acidic solution and iodine, a slight burning sensation may occur in the treatment area.

Colored. To clarify the nature of tumor neoplasms, the neck is treated with special green or blue dyes.

Luminescent. The surface of the mucosa is treated with luminescent dyes, which are absorbed by cancer cells and stain them pinkish-blue under ultraviolet irradiation.

Video: Indications for colposcopy. Features of the

Survey results

Normally, the vaginal part of the cervix should have a smooth and shiny pink surface, under which evenly distributed vessels are visible. Based on the results of a colposcopic examination, the doctor can make a conclusion about the presence of pathologies of varying degrees of danger:

The transition of the cylindrical epithelium of the cervical canal to the squamous epithelium of the vaginal part of the cervix (ectopia).
Ulceration, swelling, formation of cysts in the area of displacement of the mucous membranes.
The appearance of warty growths on the throat of the neck (leukoplakia).
Inflammation, dysplasia, mucosal atrophy (such areas are called iodine-negative, since they do not stain with Lugol's solution).
The formation of papillomas (HPV), which, like dysplasia, can be detected when the surface is treated with acetic acid.
vascular changes. They talk about either severe dysplasia or the occurrence of a cancerous tumor.

You can see the growth of the endometrium in the neck and vagina.

Possible Complications

Complications occur extremely rarely, no more often than with a regular gynecological examination. If there are ulcers or warts on the surface of the cervix, then bleeding sometimes occurs during the treatment of the mucosa. Theoretically, it is possible to introduce infection into wounds on the surface of the neck.

After the examination, a woman may feel pain in the lower abdomen due to injury to the mucosa. Brown or pink spotting may occur for 2-3 days after the procedure, especially if a biopsy was performed.

A warning: If a discomfort do not go away within 3 days, pain in the lower abdomen increases, bloody or purulent discharge, the temperature rises, the woman needs to urgently consult a doctor. It is also impossible to ignore the change in the nature of menstruation after a colposcopy of the cervix (increased volume, increased pain).

In order not to provoke the appearance of complications after such an examination, a woman is advised to avoid physical activity, thermal procedures, washing in the bath, douching, as well as sexual intercourse. Do not take blood thinners (such as aspirin) for a week.

Women are recommended to undergo a colposcopic examination at least once a year for preventive purposes, and if signs of pathology are found, this should be done once every 3-6 months (depending on the type of violations found).

Features of colposcopy during pregnancy

If, after the onset of pregnancy, a woman has erosion, dysplasia or other diseases of the cervix, then special monitoring is required for the condition of the organ. Pregnancy can provoke the development of pathology, as it changes dramatically hormonal background and the condition of the uterus. If the disease progresses and the cervix is significantly damaged, then the woman will be able to give birth only by caesarean section.

Colposcopy helps to detect early changes and choose the most gentle treatment method. The study is complicated by the fact that during pregnancy, even in a healthy woman, the state of the mucous membrane of the cervical canal of the uterus changes significantly: the work of the glands increases and the volume of secretions increases.

However, colposcopy during pregnancy is not only not contraindicated, but also necessary to identify pathologies that are dangerous for the baby, as well as to diagnose precancerous diseases. If cervical damage is insignificant, then treatment is carried out after childbirth.

Video: How a colposcopy is performed. Deciphering the results

Content

Colposcopic examination is one of the most common ways to diagnose gynecological diseases. Faced with such an appointment for the first time, women do not know how cervical colposcopy is performed, what it is, whether this procedure is painful and whether special preparation is needed for it. Meanwhile, this examination is the most important tool for identifying a number of pathologies dangerous to health.

What is colposcopy in gynecology

Colposcopic examination is an examination of the walls of the vagina and the outer part of the cervix, which is carried out using special optical equipment - a colposcope. This device is equipped with a special optical and lighting system that provides increased visibility internal organs 10-40 times, helping to conduct a thorough examination and reveal even minor pathological changes that are invisible to the naked eye.

More modern equipment for conducting such a study is a video colposcope equipped with digital camera. With its help, the image of the examined internal organs is displayed on the monitor. The results of video colposcopy are stored, and subsequently, specialists can view them, analyzing the effectiveness of treatment or evaluating the progression of pathological processes.

Indications

Since colposcopy is used to diagnose many gynecological diseases, it has big number indications for implementation. This survey be sure to appoint with unsatisfactory results of the smear analysis for cytology and if genital warts are detected during the examination. In addition, a doctor may recommend a colpo test to a woman if she has the following symptoms:

prolonged pain in the lower abdomen;
vaginal discharge, itching;
vaginal bleeding not associated with menstruation;
spotting and pain during intercourse.

Also, colposcopy can be prescribed in the absence of clear indications as an examination necessary to evaluate the results of the treatment. This procedure has no strict contraindications. The only limitation to its implementation is hypersensitivity to acetic acid, iodine preparations or other reagents that are used in extended colposcopy.

How is it carried out

When going for a colposcopy for the first time, women ask questions about how the procedure is done and whether it hurts. Colposcopy is carried out after a general gynecological examination, which is carried out with the help of mirrors and allows only a superficial examination of the cervix. After it, the gynecologist proceeds directly to colposcopy, examining the cervix through the lens of the colposcope using different magnifications.

If only a visual examination of the internal organs is performed, colposcopy is considered simple, and when the doctor uses any additional tests to detect changes in the mucous membrane, this version of the procedure is called extended. If pathological areas are detected, a biopsy is performed - taking a fragment of the affected tissue for analysis.

What shows

Colposcopy of the cervix helps to identify vascular changes in the mucosa, accurately diagnose diseases such as endometriosis, ectopia, erythroplakia, dysplasia and leukoplakia, and study in detail the nature and stage of development of erosion or other lesions. With the help of colposcopy, a gynecologist can identify oncological pathologies in the early stages of development - malignant neoplasms.

When is the best time to do

On what day of the cycle is a colposcopy performed? The recommended time for this procedure is the first half of the cycle, and best of all, if it can be completed in the first 3-5 days after menstruation. During menstruation, such diagnostic tests are not prescribed. Colposcopy during pregnancy is not prohibited and can be prescribed at different times.

Preparation for colposcopy

Having learned about the features of cervical colposcopy, what it is and when they do the examination, it remains to find out how to prepare for it. To this diagnostic procedure was as informative as possible, a few days before the visit to the gynecologist, you will need to follow some rules regarding intimate hygiene, medication and sexual activity. If a doctor has prescribed a colposcopy for a woman, she needs to:

at least 2 days before the procedure, refuse sexual intercourse;
within a week before the examination, do not douche, do not use by special means for intimate hygiene;
refrain from using contraceptive creams, vaginal suppositories or sprays unless directed by a physician knowledgeable about the upcoming procedure.

What is an extended cervical colposcopy

What are the features of an extended colposcopy of the cervix, what is it, and how are its results interpreted? After a visual examination, the doctor uses a swab to apply a little 3% solution of acetic acid to the cervix. Under his influence blood vessels in the mucous membrane narrow, and this makes any pathological changes more pronounced and noticeable.

In addition to acetic acid, additional examination iodine or special reagents can be used that can glow under ultraviolet radiation. If there are affected areas on the cervix, then when iodine is applied, they will not turn into dark color, which will allow the doctor to accurately determine their localization and scale. When using other reagents, the affected tissues can turn into a certain color under the light of an ultraviolet lamp.

Colposcopy results

After the end of the procedure, the specialist draws up a written protocol - a form that contains information about the features of the state of the cervix and the presence or absence of signs indicating the possible development of pathologies. The interpretation of the results of colposcopy may contain descriptions of such anomalies as the formation of pathological vessels, the presence of whitened areas after treatment with acetic acid, the presence of areas that are not stained with iodine.

Colposcopy is a safe examination, does not cause side effects and complications such as pain or bleeding, and does not require recovery time. In rare cases, after the procedure, there may be mild pain in the lower abdomen or slight discharge containing iodine impurities, which disappear after 2-3 days.

Video: colposcopic examination

Special video materials will help you learn more about colposcopy and methods for deciphering its results. In them, experts disclose in detail information about the features of the survey, give advice on preparing for it and talk about all the stages of its implementation. After watching the video, the woman will not have any unanswered questions.

In gynecology, colposcopy is one of the most common methods for diagnosing diseases that affect the genitals of a woman. Lack of awareness about colposcopy leads to unreasonable worries before the procedure and expectations of unpleasant sensations during it. Therefore, light should be shed on this method and understand what colposcopy is in gynecology.

Colposcopy refers to the examination of the cervix under magnification using special device, colposcope.

Often, patients are worried that the procedure is too long, so they wonder how long the colposcopy lasts. The duration of the study is a maximum of 30 minutes, and you should not be afraid of it.

There are simple and extended colposcopy. In the first case, during the examination, it is possible to determine the shape and size of the organ under study, as well as to identify its defects. More informative second method of colposcopy, which requires the use of additional tests.

A solution of iodine or Lugol can be used as a developer. When they are applied, unhealthy tissues change their shade, while the affected ones do not change. Various filters are used for better visualization. The technique allows you to effectively identify those tissues that are most suspicious.

When identifying areas of the epithelium with manifestations of pathology, a biopsy is performed. This operation is absolutely safe and practically painless. In addition to mild discomfort, the woman will not feel anything. If a biopsy of the vulva or vagina is necessary, local anesthesia is used.

Fears regarding pain or the likelihood of the formation of erosive processes are completely groundless.

Indications for the procedure

Colposcopy in gynecology is an indispensable procedure, as it makes it possible to detect a number of pathologies in the gynecological sphere.

As a result initial examination patients, the following symptoms may be the basis for the appointment of colposcopy:

non-specific discharge from the vagina, irritating the mucous membrane, which causes itching;
bleeding not associated with menstruation;
pain during intercourse and after it;
the presence of pulling uncharacteristic pain in the lower abdomen.

If it is necessary to undergo gynecological manipulations, some women experience a psychological barrier and a misunderstanding of why colposcopy is needed. You should be aware that there are a number of diseases that require mandatory this study. These diseases include those listed below.

Endometriosis. With its development, ectopic formations of the endometrium are observed. With the help of colposcopy, the presence of this process in the vagina or on the cervix is \u200b\u200bdetermined.

Erosion. Colposcopy with erosion of the cervix makes it possible to see pathological cracks, which are presented multiple times on the mucous membrane of the organ. In addition, the study reveals early stage the development of various types of tumors.

Cancer. The development of oncology that affects the cervix becomes a consequence of the activity of the papillomavirus when a woman is infected. With the help of colposcopy, it is possible to recognize the nature of the processes and prevent the development of a cancerous tumor at an early stage.

Polyps. These unpleasant neoplasms are easily detected during a colposcopic examination.

Erythroplakia, or leukoplakia. Timely diagnosis of changes in the thickness of the epithelial layer allows you to take appropriate measures for the treatment of the disease.

Advantages and disadvantages of the method

Often, circumstances develop in such a way that when it is necessary to do a colposcopy, women have doubts about the safety and necessity of the procedure. For an objective understanding of the impact of this type of diagnosis on health, all the pros and cons should be weighed.

Colposcopy, like no other technique, has a high diagnostic value. With its help, the doctor receives full information about the condition of the tissues possible pathologies, oncological changes, as well as the presence of tumors and inflammation. As a result of the study, the reliability of the diagnosis is maximum. If necessary, the doctor can take an image and review it again if in doubt.

Colposcopic examination is simple, and there is no need for complex preparation of the patient. Despite the complexity of the event, it is completely painless.

The disadvantages of the technique include the possibility of conducting a study only in women who are already sexually active. The event cannot be carried out during menstruation, which somewhat limits its possibilities.

In addition, a prerequisite is the need to take into account the individual cycle of a woman in order to be able to obtain the full amount of required information. Thus, sometimes it takes some time from the moment of contacting a doctor.

The chance of complications is minimal.

Contraindications

Contraindications to colposcopy are divided into absolute and temporary. To assess possible absolute contraindications, one should take into account which of the diagnostic methods will be used.

With a simple colposcopy, there are no absolute prohibitions on its implementation, since the procedure is not much different from a regular gynecological examination. The only difference is that the colposcope is installed at some distance from the entrance to the vagina.

If colposcopy involves the selection of biological material in which certain substances are used, then there is a possibility of developing an allergy. In addition, individual intolerance to these solutions is possible.

Despite the safety of this gynecological procedure, it should be understood that there are some temporary prohibitions on colposcopy.

Contraindications may be:

the presence of an inflammatory process;
the period from the moment of birth is less than 1.5-2 months;
recent surgical intervention in the treatment of the cervix;
the period from the moment of abortion is less than 3-4 weeks;
the presence of bleeding.

Thus, to the question of whether colposcopy is done during menstruation, the answer is unambiguously negative.

Training

Before the event, you should read the information on how to prepare for a colposcopy.

Women often have the question of whether it is possible to have sex before a colposcopy. Doctors recommend limiting sexual intercourse immediately before the procedure. The minimum period of abstinence is one day.

If menstruation occurs at this time, the examination is postponed. Tampons should not be used.

Before starting the examination, douching, the use of vaginal suppositories, sprays and tablets should be excluded. Hygiene procedures should be carried out exclusively with the use of water, detergents however, should not be applied.

Patients should know on which day of the cycle the colposcopy is done. To obtain the most reliable data, the study is carried out on the 9-20th day after the end of the menstrual cycle. If there is an urgent need urgent diagnostics, then you can not expect the onset of this period, the main thing is that there should be no menstruation.

If the menstrual cycle fails, the doctor should be warned about this, then the specialist will be able to realistically assess the condition of the mucosa. Thus, colposcopy can be performed on any day of the cycle.

How is the procedure carried out?

Literally translated, the name of this diagnostic method means observation of the vagina. The main focus of the procedure is to identify pathological changes in the cervix. The design of the colposcope consists of a binocular microscope, which allows you to get a stereoscopic image.

The binocular is capable of magnification from 4x to 40x. The tripod of the device is equipped with an illuminator.

Expensive models have additional equipment that allows for photo and video recording, which makes it possible to monitor the dynamics of the treatment process.

The procedure of an ordinary gynecological examination is preliminarily carried out, and if a pathology is suspected, a colposcopy is prescribed. A simple procedure, as we have already noted, is to visually inspect the object of study.

Detailed examination involves sampling of the epithelium and tissue staining. Previously, the area around the cervix is treated with a low-percentage solution of vinegar. As a result of this action, there is a short-term swelling of the mucosa and a slowdown in blood circulation. In this case, there is a reduction in small vessels. If this did not happen, then such a phenomenon is evidence of vascular atypia.

After that, Lugol's solution is applied, which lubricates the area around the cervix. This body has stratified epithelium, which contains glycogen capable of reacting to the components of the solution.

During chemical reaction staining of a healthy cervix occurs evenly. If during colposcopy the area is not stained with iodine, then this indicates pathological changes on it. The explanation for this is the properties of the cylindrical epithelium, which are poorly stained with iodine-containing substances.

If a pathology is detected, then the doctor decides on the need for it. This means that a small piece of tissue is taken for histological examination. The tool for this operation are special tweezers, so you may experience discomfort, reminiscent of a spasm or mild pressure.

After the procedure

If the colposcopic examination was not accompanied by a biopsy, then you can lead a normal life, there are no restrictions on work. If there is bleeding after a colposcopy, then this is not a cause for concern. After one, maximum three days, the discharge will stop.

Burning after colposcopy is possible for a short time if a biopsy was performed. But this is not the only unpleasant by-effect procedures. No need to be scared if your stomach hurts after a colposcopy. After a couple of days, the discomfort will go away.

We hope that we have dispelled all the doubts and fears that some women associate with colposcopy. The importance of this procedure for making a diagnosis can hardly be overestimated, since a correct diagnosis and adequate treatment will help not only maintain the patient's health, but also give a new life.

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