How is a colposcopy performed?

In clinical practice, colposcopy is of great value. It has many advantages. For example, colposcopy is almost non-traumatic and causes less harm to patients, so it can be examined repeatedly. In addition to examining diseases, colposcopy also has a therapeutic effect, and the accuracy of colposcopy treatment is relatively high. Many people do not know how colposcopy is done. Let's learn about the detailed process below.

How is a colposcopy performed?

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. The columnar epithelium is not stained, the primitive squamous epithelium is stained dark brown, and 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.

Precautions

1. Avoid using lubricants when inserting a speculum.

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

3. The optimal action time of 3% acetic acid test is 10-20 seconds.

4. Iodine testing helps beginners avoid missed diagnoses.

5. Fully expose the cervical canal to avoid misdiagnosis.

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

7. The timing of surgery is as follows: 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 cervical canal; ③ For other diseases, it is advisable to perform the surgery within 2 weeks after the end of menstruation.

Preparation before the examination

1. Routinely inquire about medical history and menstrual history to choose the appropriate examination time.

2. Routine trichomoniasis, fungus, and Pap smear examinations.

3. For those suspected of infection, vaginal and cervical secretion cultures should be performed, and those with positive results should be treated symptomatically first.

4. Gynecological examinations and other vaginal procedures are prohibited 24 hours before surgery.

5. Vaginal medication is prohibited 48 hours before surgery to prevent the drug from adhering to the surface of the vagina and cervix and affecting the examination results.