Colposcopy precautions

Colposcopy precautions

There are many things to pay attention to when doing a colposcopy. The most important thing is to prevent yourself from scratching the cervix during the examination. You must go to a regular hospital for relevant examinations to ensure that there is no bacterial infection in your body. In addition, the patient must maintain a calm mood and not look too nervous, otherwise it will make the examination difficult.

1. Avoid using lubricants when inserting a speculum.

2. The speculum should be inserted while dilating under direct vision to avoid scratching the cervix.

The optimal action time of 3.3% acetic acid test is 10-20 seconds.

4. Iodine test helps beginners avoid misdiagnosis.

5. Fully expose the cervical canal to avoid misdiagnosis.

6. Do not ignore those who move into the transformation zone.

7. Choice of surgical time: ① There is no time limit for suspected cervical cancer or precancerous lesions; ② It is advisable to perform the surgery close to or during the ovulation period for lesions in the endocervical canal; ③ For other diseases, it is advisable to perform the surgery within 2 weeks after the end of menstruation.

The patient takes the lithotomy position, places a vaginal dilator, and then gently wipes off the mucus on the surface of the cervix with a sterile gauze ball. After adjusting the diopter of the colposcope eyepiece, adjust the focal length of the colposcope to sequentially expose the changes in the examination areas, namely the transformation zone, epithelium, blood vessels, etc.

During the examination, 3% acetic acid solution should be applied to the surface of the cervix. Under the action of acetic acid, the columnar epithelium will become edematous and slightly white, forming a grape-like shape, while the squamous epithelium will become slightly white without any grape-like changes. This can be used to distinguish the squamous epithelium from the columnar epithelium of the cervix. After the acetic acid test, 1% iodine solution is routinely applied evenly to the surface of the cervix, and the columnar epithelium is not stained.

The primitive squamous epithelium stains dark brown, while the metaplastic squamous epithelium shows different shades of staining depending on the degree of maturity of its metaplasia. In order to observe the changes in blood vessel morphology more clearly, a green filter can be used for examination. At the same time, normal blood vessels contract immediately under the action of acetic acid, while abnormal blood vessels do not have this change, which helps to identify the nature of the blood vessels.

The purpose of colposcopy is to: ① timely diagnose precancerous lesions of the lower genital tract to reduce the incidence of cancer; ② timely diagnose early cancers such as carcinoma in situ and microscopic early invasion so that patients can receive early diagnosis and treatment, thereby improving the survival rate of patients with malignant tumors; ③ avoid blindly performing traumatic multi-point biopsies on the lower genital tract, and only perform biopsies on suspicious lesions under colposcopy, which not only reduces damage but also increases the positive detection rate; ④ increase the diagnostic positivity rate of subclinical genital warts to improve the treatment effect, effectively control the spread of sexually transmitted diseases, and thus achieve the purpose of preventing the occurrence of malignant tumors of the lower genital tract; ⑤ determine the extent of the lesion and formulate a correct treatment plan.

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