A colposcopy is a test in which the doctor uses an instrument called a colposcope to look at the cervix with magnification. The colposcope looks like a pair of binoculars mounted on a pedestal with a light attached. This instrument magnifies the cervix, vagina and external genital area when the doctor looks through the lenses into the vagina where a speculum has been placed. Different colored filters, similar to those used for cameras are used to block out colors. Magnification helps to see abnormal areas clearly so that biopsies (pieces of tissue) can be done precisely. The pieces of tissue are looked at in the laboratory under a microscope. After all the biopsies are taken, a scraping is done inside the cervical canal to make sure there are no abnormal cells past where the doctor can see. These scrapings are also sent to the lab to be looked at under the microscope. A colposcopy is done when abnormal cells are seen on a Pap Smear.

The patient will take 600-800 mg of Aleve or Advil one hour before leaving for your doctor’s office. If you are allergic to ibuprofen, take two Extra-Strength Tylenol. Make sure you have not started nor will start your period for about two weeks. Do not use anything in the vagina for 24-48 hours before the procedure. This includes spermicides, vaginal medications, douching products or tampons. These all interfere with the accuracy of the test. And do not have vaginal sex 24 - 48 hours before the procedure because this can also interfere with teh test’s accuracy. The patient will lie on the examining table just as in a regular pelvic exam. The colposcope is placed at the vaginal opening in order to examine the genital area, vagina and cervix.

The doctor will use a speculum, the same as used during your regular examination, to separate the walls of the vagina as in a pap smear. The speculum will be moistened with warm water and stays in the vagina throughout the procedure. Upon insertion of the speculum, inspection of the vaginal walls will be done. The speculum will be gently rotated so that the entire vagina can be seen. Next, the speculum is placed so that the cervix is completely visible. While looking through the colposcope, your doctor will do a Pap Smear that will be sent to the lab with any other tissue samples, called biopsies, that may be taken dung your examination. The Pap Smear is done as usual, making sure that cells from the Transformation Zone are included in the smear. The doctor will then look at your cervix under 2 - 3 different magnifications. Any excess mucus or other secretions will be cleaned from the cervix using a large cotton swab.

After this, a cool sensation will be felt. This is the application of acetic acid, a vinegar solution that will enable abnormal cells to be more visible. This may sting a bit. Acetic acid dissolves mucous and accentuates atypical areas by causing cellular dehydration and coagulation of cellular protein. The effect of the acetic acid peaks in approximately 2 minutes and fades in approximately 5 minutes. Because of this, your doctor may need to re-apply the acetic acid solution several times. Areas of the cervix may turn white after the acetic acid has been applied. These areas are called White epithelium. White epithelium is sometimes associated with dysplasia. These areas will be biopsied by the doctor near the end of the procedure.