Colposcopy of the cervix

Update: December 2018 Colposcopy is the modern standard.
gynecological examination procedure of the vagina, cervix and vulva
women. For its implementation, the gynecologist uses a colposcope, with
special lighting and optical system. Holding such
procedures are usually recommended if the doctor detects
pathological condition of the cervix, vagina during a routine examination
or cytological smear has abnormalities. However, there are
случаи, когда можно заподозрить рак кольпоскопически при
in the absence of complaints from the patient, with normal cytology and visual
examination of the cervix. То есть кольпоскопические признаки
appear much earlier cytological, and, moreover,
visual. This is a very valuable method for detecting cancer in
very early stage and heal it. This procedure should be included in
compulsory examination for all women registered in
antenatal clinic (myoma, endometriosis, etc.).

Ideally, colposcopy should be done at least once a year.
absolutely all women. Abroad, this procedure is carried out
a woman every year, but a smear on cytology is taken every 5 years
(colposcopy is cheaper).

During a colposcopy, the doctor may detect any
education and take a biopsy for thorough laboratory diagnosis
abnormal cells. Before primary colposcopy most women
worried because they have not enough information about the essence of this
procedures and results of such a diagnosis.

The purpose of such a diagnosis?

Very often it is during erosion of the cervix, colposcopy is
important diagnostic procedure. It is used to
timely diagnose and timely treat such diseases
female genital organs like:

  • Genital warts, papillomas
  • Cervical cancer
  • Pre-cancerous conditions of the vulva, vagina, cervical tissue
    uterus
  • Цервицит — воспаленные процессы шейки uterus
  • Vaginal or vulvar cancer
  • Полипы шейки uterus

Therefore, the indication for the procedure is any
deviation from the norm when examining or analyzing a smear, and
there are no contraindications for it, except for the period
menses. Based on the diagnostic results, the doctor prescribes
appropriate treatment.

Подготовка к кольпоскопии шейки uterus

As a rule, it is recommended to carry out the procedure after
monthly in the first 2-4 days. In the case where a survey is scheduled,
and the woman began to have menstrual flow, the procedure should be
to transfer. To prepare for cervical colposcopy, you should:

  • 2 days before a colposcopy, it is worthwhile to abandon the genital
    contacts
  • The same applies to the use of various candles, sprays,
    vaginal tablets if the doctor did not recommend anything
    use specially.
  • Do not use intimate hygiene products, but wash the genital
    organs only water.
  • You can not make an independent douching for a few
    days before colposcopy, especially since douching itself
    is not a safe method of treatment (see. All about douching –
    harm or benefit, how to do douching).
  • No painkillers are required before colposcopy.
    – it is absolutely painless inspection, the same as before
    examination of the gynecologist, just introduced a mirror, and the neck is examined
    under magnification, nothing to do with it.

How is colposcopy performed

На кольпоскопическую картину могут повлиять и извратить ее
не в лучшую сторону такие факторы, как слизь и пальпация uterus и
appendages, therefore:

  • The doctor removes mucus from the cervix and treats with vinegar and lugol
    Be sure to wadded, not gauze.
  • Кольпоскопия делается до пальпации uterus и придатков (то же
    the same concerns exclusion of sexual intercourse the day before).

Colposcopy can be extended and simple.

Оборудование для кольпоскопии

Simple colposcopy – when the inspection is done immediately after
удаления отделяемого с поверхности шейки uterus.

Extended colposcopy – after treatment
the vaginal part of the neck with a 3% solution of acetic acid and 
After 2 minutes, the examination begins with a colposcope. After
such treatment any pathological changes become more
clearly identified because the surface of the cervix occurs
short swelling of the mucous membrane, reduced blood supply
tissues. To determine the oncological location of cells,
use a solution of Lugol (Lugol in angina.) This method is called
пробой Шиллера, при предраковых заболеваниях клетки шейки uterus
tissues are poor in glycogen and when iodine or lugol is applied
painted in a dark color. Therefore, during the oncological process on
against the brownish fabric traced whitish spots. Then
the doctor can take a biopsy – a piece of tissue for histological
research.

Biopsy – the procedure is a bit painful, because
special tongs. Биопсия шейки uterus считается
slightly painful, sometimes there can only be a weak sensation of pressure
and spasmodic pain. But with a biopsy of the vagina or vulva may
be painful, use a local anesthetic for this. AT
In some cases, the doctor may apply and special means,
reducing bleeding. With a biopsy, the gynecologist separates a small
фрагмент ткани шейки uterus, помещая его в пробирку и направляет в
the lab. After кольпоскопии с биопсией остается маленькая 3-5
mm scratch that heals quickly in a few days. Sometimes in
in cases when there is less than 14 days left until the next menstruation,
A biopsy may be scheduled for another day.

After 10-14 days, usually the results of the biopsy are ready, so after
Colposcopy needs to be arranged with your doctor about your next visit when
will be ready to analyze to get recommendations related to
survey results.

What can cervical colposcopy results mean?

If a doctor with an extended colposcopy detects altered
plots, in some cases a biopsy is taken. With cervical erosion
uterus (эктопии), пораженный участок не окрашивается Люголем, это
only proves the presence of ectopia and biopsy is not indicated. But
if a:

  • visible pathologically altered vessels (convoluted, intermittent, in
    comma, etc.)
  • punctuation is dotted on the uncolourable Lugol
    plot
  • мозаика – это в виде четырехугольников различной формы
    опять же на не окрашиваемом plot
  • whitish areas unchanged – leukoplakia

then a biopsy is required.

Even with detected changes, only one appearance
the doctor will not be able to establish the diagnosis, everything will depend on
laboratory data after 2 weeks. When did the histological analysis
will detect tissue change, then you will need to
additional examinations and therapy according to the result of the analysis.

What can not be done after colposcopy and biopsy?

If there was a colposcopy without a biopsy, then everything is possible
I want to.

And if the colposcopy was with a biopsy, then after
procedures are possible:

  • after a biopsy, women can have pulling for 4-10 days
    lower abdominal pain
  • appear scanty greenish or brown discharge (see
    Brown discharge in the middle of the cycle). Don’t panic, it’s
    variants of the norm.

To avoid complications after colposcopy with biopsy in
Within 2 weeks you should follow some rules:

  • Exclude sex
  • Do not douche, use tampons, and use
    gaskets only
  • You can not drink medicines, which include
    acetylsalicylic acid
  • Limit any heavy exercise, exercise
  • You can not visit the bath, sauna, exclude bathing, should
    take a shower only

Colposcopy during pregnancy and biopsy

For colposcopy, pregnancy is not a contraindication.
Because it is a painless and safe method. At colposcopy
only one contraindication – the period of menstruation.

But биопсию, лучше не делать, поскольку:

  • It can cause bleeding, miscarriage, premature labor,
    especially in situations where previa is detected
    placenta.
  • And not only therefore, but also because of possible
    ложноположительных результатов патологических изменений шейки
    uterus под действием гормонов во время беременности.
  • In addition, to treat, if anything, it is still not possible until
    a woman will not give birth (the exception may be cervical cancer, and
    running).

Поэтому чаще всего, проведение биопсии шейки uterus при
Doctors do not do pregnancy and postpone the procedure for a period
after childbirth. Colposcopy without biopsy during pregnancy is safe and
даже если обнаруживаются изменения шейки uterus, уже через 6 недель
after the baby is born, colposcopy can be repeated and
produce the necessary biopsy.

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