Colposcopy type 3

Under direct illumination of a strong light source, colposcopy can be used to immediately observe epithelial cell lesions in the vagina and cervix, which are magnified 6 to 20 times, thereby allowing the observation of subtle lesions in the vagina and cervix that are invisible to the naked eye. Accurately positioned puncture biopsy can be performed on abnormal parts, which can improve the diagnosis rate.

Preparation before inspection

1. Understand the medical history and menstrual history to choose the appropriate examination time.

2. Basic secretions are checked for Trichomonas, bacteria, and Papanicolaou acid-fast staining.

3. For those with abnormal infection, vaginal and cervical canal secretion should be performed. Those who test positive should be treated with medication first.

4. Sexual intercourse is prohibited 72 hours before the operation. Vaginal cleaning and medication are strictly prohibited 48 hours before the operation to prevent the drugs from adhering to the vagina and cervical surface and affecting the examination results. Gynecological examination and other vaginal operations are prohibited 24 hours before the operation.

Indications

1. Those whose cervical cytology examination shows Pap test grade II or above.

2. People with abnormal cervical deterioration in human eyes.

3. There is irregular bleeding, but no obvious changes in the cervix can be observed by naked eyes.

4. Those with diseases in private parts and vagina.

5. Those whose disease scope is clear before cervical conization.

Contraindications

There are no absolute contraindications to colposcopy. Its relative contraindications, namely the contraindications of endoscopic puncture biopsy, are inflammatory reactions of the reproductive system, heavy vaginal bleeding, and cervical malignant tumors.

Inspection process

1. After the patient has emptied his bladder, he takes the lithotomy position and uses a vaginal speculum to expose the inside of the cervix and vagina.

2. Use cotton wool to gently wipe away cervical secretions and mucus.

3. Observe the shape, size, color, spots and growths of the cervix with your eyes.

4. Turn on the lighting power switch, adjust the objective lens to the same level as the inspected position, adjust the objective lens distance, generally about 20 cm away from the cervix, and adjust the focal length of the objective lens until the virtual image is clear. Under white light, use a 10x low-power scope to roughly observe the shape, color, and blood vessels of the cervix, and then use a high-power scope to identify cervical diseases.

5. Use cotton wool dipped in 3% to 5% glacial acetic acid to rub the surface of the cervix. Under the action of glacial acetic acid, the columnar epithelial cells swell and turn slightly white and appear like red grapes, while the squamous epithelium turns slightly white without any red grape-like changes. This is used to distinguish between squamous epithelium and columnar epithelial cells. After 1 to 2 minutes, the color change will be complete, and the abnormal changes should be carefully observed. For long-term observation, 3% to 5% acetic acid solution should be applied repeatedly every 3 to 5 minutes. In order to clearly observe the changes in blood vessel shape, green filter lenses can be used for inspection. After the acetic acid test, the surface of the cervix was wiped with spiny seed iodine solution. The initial squamous epithelium was dark brown, the columnar epithelial cells were not colored, and the squamous epithelium of the metamorphosis temple showed different shades of color depending on the degree of perfection of the metamorphosis temple, thereby determining the location and scope of the lesion. The iodine test-negative area (uncolored area) is the location of the abnormal lesion. A puncture biopsy is taken from the negative area and sent for pathological examination.

Frequently asked questions

1. Do not use lubricant when inserting the vaginal speculum. The dilator should be inserted while expanding under the eyes to avoid scratching the cervix.

2. Patients with abnormal changes should undergo biopsy under colposcopy.

3. Adequately expose the cervical canal to avoid misdiagnosis and pay attention to those who move into the transition zone.

4. Inspection time selection: there is no time limit for suspected cervical cancer or cervical epithelial neoplasia. The inspection of cervical canal lesions should be close to the ovulation period or ovulation period. Other symptoms should be within 2 weeks after the menstrual period is over.

5. Colposcopy cannot clearly detect diseased tissue.

6. The coordinated use of colposcopy and cytology can reduce the misdiagnosis rate.