Colposcopy what is the procedure in gynecology?
Statistics of gynecological diseases in Russia is relentless. Since 2008 marked (and continuing) increase in the number of inflammation of female genital sphere – almost 10% of cases of endometriosis by 27% and cancer by 7%. And this is only the quantitative indicators among the surveyed women, and how much more those who do not attend the gynecologist! Colposcopy occupies a niche of screening studies. In Russia it covers approximately 60% of women, which is considered very low. Let’s look into what a colposcopy in gynecology?
The survey is an inspection of the female genital organs, namely the vulva, vagina and cervix using a special optical device. The aim of this study is the diagnosis of inflammatory, cancer, infectious diseases in gynecology at an early stage. The examination a colposcope is a microscope with multiple magnification, equipped with lighting. It has a binocular head, a base and a tripod with which you can rotate or tilt the device. Thus, the physician has the capability of contactless inspection bodies. By the way, now there are modern equipment for examination, where the image is displayed on the monitor screen (digital colposcopy). The latter will soon take the place of the old optical techniques.
There is colposcopy:
- using color filters.
The second is no longer used because it does not give the doctor any useful information. The advanced method involves the use of special chemical reagents for staining of lesions of the mucosa. Which sample holds the doctor? They are only 6, although, in practice, used only 3.
Test with acetic acid
Reaction with 3% solution of acetic acid involves the process it areas of the mucous. After 1-2 minutes of normal healthy tissue is uniformly pale due to spasm of blood vessels (positive test). If there are pathological lesions, where the artery is not sensitive to vinegar, the color will not change. The sample in the latter case is negative, which speaks in favor of the disease (often malignancy).
It is carried out immediately after the first test. Used 3% Lugol solution with glycerin, which is also painted cervix brown. Visible unpainted areas indicate pathology, are take material for biopsy. Schiller’s test does not allow to answer the question about what process was going on. Only the results of histological studies to solve this problem.
Test with adrenaline
Used to determine the reactivity of the vessels of the vaginal mucosa and cervix (especially in areas with erosion) and gives good results. Examination through colored filters and other types of colposcopy allow to thoroughly examine the epithelium and vascular pattern.
Indications for examination
Sometimes during a normal visual inspection of the doctor remain doubts about the correct diagnosis. In order to dispel them, there are additional and more accurate diagnostic methods, a General and a PAP smear, scraping, seeding is carried out at colposcopy. To the procedure there are certain indications, just a women it is not carried out.
The examination shall be appointed in the following cases:
- Bleeding from the genital tract;
- Infertility (along with other diagnostic techniques);
- Control after treatment;
- The presence of erosion and pseudo-erosion, polyp, condyloma;
- Cancer of the genital organs (in order to rule out metastasis);
- Detection of atypical cells in a PAP smear or suspicion of malignancy (mandatory indications for colposcopy);
- The duration of the inflammatory diseases of the genital organs in women.
Mandatory and urgent indication (need) for a colposcopy is to identify atypical cells in a smear!
The procedure for the examination of the cervix under a microscope has virtually no restrictions, however, some contraindications to colposcopy.
- Menstrual or other bleeding.
- The postnatal period (60 days).
- Allergy to iodine (this is a relative contraindication to colposcopy).
Preparation for the examination
To have the procedure extended colposcopy was successful, and for 3-4 days it is necessary to exclude sexual life, treatment of vaginal preparations (candles, tablets, douching). Also important day of the cycle. Do not appoint a colposcopy during your period or immediately after it. Pregnant women can be diagnosed any day.
The technique of the
What is this procedure and how it is performed? For women, this study hardly differs from the usual inspection on the gynecological chair. Some women feel a slight pain. Colposcopy when erosion may cause burning due to the application of the reagents. With a low pain threshold it is recommended that before the examination to drink antispasmodic.
After the location of the mirror the doctor approximates the colposcope and begins a phased survey. First, conduct an audit of the vulva and vaginal walls and cervix. A thorough inspection under multiple magnification allows you to study color, relief, rugosity of the mucosa, vascular pattern, shape and contour of organs, appearance of the epithelial, separation.
The most frequent findings during the inspection are:
- Erosion and pseudo cervix;
- Dysplasia of the epithelium;
- Leukoplakia (precancerous means disease);
- Polyps and adenomatosis (also pre);
- Inflammation and hyperplasia of the mucous;
- Atrophic processes in the elderly;
Many identified by colposcopy diseases require a biopsy for cytohistologic research to clarify the diagnosis, determine the extent, stage and type of the pathological education. Special scalpel or forceps, the doctor takes a small piece of modified tissue in sterile tube, send to laboratory. The procedure of colposcopy takes 15-20 minutes at the time, and if necessary scraping, a little longer. After taking mucosa to analyze the woman recommended protective mode.
What not to do after a colposcopy:
- Not to douche;
- Not sexually active;
- Not to take a bath.
After the procedure a colposcopy possible spotting for several days (usually this happens when the erosion)!
Complications (pain in the lower abdomen, bleeding, inflammation) are very rare. What to do to the woman if after the procedure there was an unpleasant symptoms? The answer is simple: immediately call a women’s clinic, and not wait for the next appointment!
The test results will be ready in a week. As a rule, the attending physician assigns appointment to the announcement of the lab conclusions and assign the required treatment. The accuracy of the survey is very high (over 87%).
Where the colposcopy?
Almost always this procedure sends a gynecologist, so where you can do a colposcopy will tell the doctor. Typically, the colposcopic study is on the basis of women’s consultation, so do not need. If the woman herself is willing to undergo colposcopy as a preventive measure, where this can be done is in commercial medical institutions on a paid basis.
Disadvantages of colposcopy
Even with such a seemingly accurate examination of possible errors and false results. In most cases, the cause of diagnostic inaccuracy is considered to be a low level of qualifications of medical personnel. That is why all of the observed pathological changes in the diagnosis (polyp, erosion, leukoplakia, etc.) made to confirm results of histological examination of biopsy material. The coincidence of opinions, the reliability of the diagnosis increased to 99%, which is of great importance for successful treatment. Despite false-positive or false-negative results, colposcopy remains the most correct and best procedure in the diagnosis of gynecological diseases.