What is a Colposcopy?

Directly observe the epithelial lesions of the vagina and cervix through a colposcopy under a strong light source, and magnify 6-20 times to observe the smaller lesions of the vagina and cervix that are not visible to the naked eye. A localized biopsy on the suspicious part can improve the diagnosis .

Basic Information

Chinese name: Colposcopy

Indication: Vaginal and cervical examination

Preparation before colposcopy

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

2. Routine vaginal trichomoniasis, fungus, Pap smear examination.

3. Vaginal and cervical canal secretions should be cultured for suspected infections. Those who are positive should be treated symptomatically.

4. Sexual ban is prohibited for 72 hours before surgery, vaginal flushing and medication are forbidden 48 hours before surgery to prevent the drugs from sticking to the surface of the vagina and the cervix, which will affect the test results. Vaginal operations such as gynecological examinations are prohibited 24 hours before surgery.

Colposcopy indications

1. Cervical exfoliation cytology examination of Pap II or above.

2. Suspicious cervical malignant person with naked eyes.

3. There is contact bleeding, and no obvious lesions of the cervix are observed by naked eyes.

4. Those with vulvar and vaginal lesions.

5. Determine the extent of the lesion before cervical cone resection.

Colposcopy contraindications

There are no absolute contraindications for colposcopy, and the relative contraindications are the contraindications for microscopic biopsy: acute inflammation of the genital tract, massive vaginal bleeding, and cervical malignant tumors.

Colposcopy examination steps

1. After the patient has emptied the bladder, take the bladder lithotomy position and expose the cervical vagina with a vaginal speculum.

2. Use a cotton ball to gently wipe off cervical secretions and mucus.

3. Observe the morphology, size, color, spot, and vegetation of the cervix with the naked eye.

4. Turn on the lighting switch, adjust the objective lens to the same level as the part to be inspected, adjust the distance of the objective lens, generally about 20 cm from the cervix, and adjust the focal length of the objective lens until the object image is clear. Under the white light, the appearance, color and blood vessels of the cervix were roughly observed with a 10x low power microscope, and then the cervical lesions were identified with a high power microscope.

5. Use a cotton ball dipped in 3% ~ 5% acetic acid to rub the surface of the cervix. The columnar epithelium swells slightly under the effect of acetic acid and becomes grape-like. The color of squamous epithelium is slightly white without grape-like changes. Epithelium and columnar epithelium. After 1 to 2 minutes, the color change completely appeared, and the suspicious lesion was carefully observed. If you need to observe for a long time, you should rub 3% 5% acetic acid solution once every 3 5 minutes. In order to clearly observe changes in blood vessel morphology, green filter lenses can be used to check. After the acetic acid test, the surface of the cervix was coated with a compound iodine solution. The original squamous epithelium was stained dark brown, the columnar epithelium was not stained, and the metaplastic squamous epithelium showed different shades of staining depending on the degree of metaplasia. Identify the location and extent of the lesion. The negative area of the iodine test (non-stained area) is the suspicious lesion. A biopsy was taken in the negative area and sent for pathological examination.

Colposcopy considerations

1. Do not use a lubricant when placing the vaginal speculum. The dilator should be placed while expanding under direct view to avoid bruising the cervix.

2. Suspected lesions should be biopsied under colposcopy.

3. Fully expose the cervical canal to avoid missed diagnosis, and pay attention to those who move in the transformation area.

4. The timing of examination, there is no time limit for suspecting cervical cancer or cervical intraepithelial neoplasia. It is advisable to understand that cervical lesions should be close to ovulation or ovulation, and other diseases should be within 2 weeks after menstruation.

5. Colposcopy can not confirm the examination of diseased tissue.

6. The combined use of colposcopy and cytology can reduce the rate of missed diagnosis.