A Pap test is only a screening test, and cannot always give the complete picture. Pap smears are only able to sample the surface layer of cells. If a Pap smear result is abnormal, a follow-up test needs to be done to find out where these abnormal cells are and what types of cells are abnormal. With the help of an instrument called a colposcope, a biopsy (tissue sample) can be taken. This biopsy provides a sample of tissue several layers thick and significantly improves the accuracy of diagnosis.

What is a colposcope?

A colposcope is an instrument mounted on a stand that is used to look at the cervix and vagina through a low-power microscope. The colposcope looks like a pair of binoculars mounted onto the end of a pole.

What is a colposcopy?

Colposcopy is a painless examination of the cervix and vagina. This exam is usually done between menstrual periods and generally takes less than ten minutes. A woman lies down in the position used to take a Pap smear and a speculum is inserted into the vagina to give a view of the cervix and vagina. Acetic acid (vinegar) is applied to the cervix, causing the abnormal cells to turn white, aiding in the evaluation.

Why is a woman advised to have an exam with a colposcope?

If the cervix looks abnormal, or if a Pap smear indicates the presence of abnormal cells, colposcopy helps in diagnosis and treatment. It may be difficult to find out the condition of the cervix by simply looking with the naked eye. A magnified view may help to clarify abnormalities or show that cervical changes are not abnormal. If abnormal cells are found, a colposcopic exam can be used to decide from which areas a biopsy should be taken.

What is a biopsy of the cervix?

A biopsy of the cervix is the removal of a small piece (or pieces) of tissue from the cervix using a specially designed instrument. This is usually done during colposcopy. The tissue sample is then sent to a laboratory where it is examined under a high-power microscope and a diagnosis is sent to our office. You will have a follow up appointment within two weeks for review of these results.

Is a biopsy painful?

Most women describe the procedure as feeling like a sharp pinch. Some experience a menstrual-type cramp. Any discomfort you experience, usually resolves quite quickly. There may be some light spotting or bleeding for a few days after a cervical biopsy. There is no medication or sedation needed for this procedure. Most patients are able to drive themselves to and from the appointment without any difficulties.

What treatment will I need?

Sometimes the examination shows that no treatment is needed, other than Pap test follow up. If minor treatment is needed, we may provide it in our office. Occasionally a hospital procedure may be recommended. In the event your condition requires more evaluation or treatment than we can provide, we will refer you to a specialist for further management.