What is the colposcopy procedure like?

For women, a colposcopy is equivalent to a surgery. During the colposcopy, it may cause heavy vaginal bleeding, so attention should be paid to relevant matters before and after the examination. Patients must go to a regular large hospital for this examination. Before the examination, they must follow the doctor's advice, such as not cleaning the vagina within 24 hours before the examination, etc. The detailed process of the colposcopy is introduced below.

Colposcopy process:

Avoid vaginal and cervical operations and treatments (flushing, gynecological examination, biopsy, sexual intercourse, etc.) within 24 hours before the examination to reduce irritation and interference to the examination site. The examination should not be performed if there is bleeding at the examination site or acute inflammation of the vagina or cervix.

1 The patient takes the lithotomy position, moistens the vaginal speculum with normal saline or does not use lubricant, exposes the cervical vault, and gently wipes off cervical secretions with a cotton ball.

2 Adjust the height of the colposcope and the examination table for appropriate examination, place the lens 10 cm away from the vulva (the lens is 15-20 cm away from the cervix), aim the lens at the cervix, turn on the light source (use an electronic colposcope, connected to a monitor), adjust the focus to make the light soft, and use a green filter lens. For more precise vascular examination, a red filter lens can be added.

3 To distinguish between normal and abnormal, squamous and columnar epithelium, the following solutions can be used:

(1) 3% acetic acid solution (97 ml of distilled water + 3 ml of pure glacial acetic acid): causes the columnar epithelium to swell rapidly, turn white, and change into grape-like shapes. After a few seconds, the junction of the phosphorus-columnar epithelium becomes very clear.

(2) Iodine solution (100 ml of distilled water + 1 g of iodine + 2 g of potassium iodide): It stains the normal squamous epithelium, which is rich in glycogen, to a brown color. It also stains the atypical hyperplasia and cancerous epithelium, which have less glycogen and are not stained. The columnar epithelium and the epithelium due to low estrogen levels are also not pigmented. The appearance of an unstained area is called a positive iodine test.

(3) 40% trichloroacetic acid (60 ml of distilled water + 40 ml of pure trichloroacetic acid): makes condyloma acuminatum appear as needle-like protrusions with clear boundaries from normal mucosa.

4. Observation contents: cervical size, range of erosive tissue, whether the cervical mucosa is everted; whether there are epithelial abnormalities and the range of lesions; vascular morphology, distance between capillaries, etc.