Colposcopy is a diagnostic instrumental method of examining the vaginal part of the cervix using binocular optics – a colposcope. With the help of a colposcope, it is also possible to conduct a study of the mucous membrane of the external genitalia – vulvoscopy. The purpose of colposcopy is to identify and determine the nature of pathological changes in the cervix, including precancerous and early stages of cancer.
The colposcope is a binocular microscope with interchangeable eyepieces placed on a tripod and equipped with an illuminator. A colposcope with an additional video camera – a video colposcope allows photo and video recording of the results of the study. Modern colposcopes have an image magnification function of 7.5 – 30 times.
The colposcopy procedure makes it possible to clarify the nature of pathological changes in the cervix revealed during an examination using vaginal mirrors. Colposcopy is also performed in order to determine the pathological focus for a targeted biopsy of the cervix and monitor its conduct. Currently, gynecology considers it necessary for every woman living a sexual life to undergo a colposcopy for preventive purposes 1 time a year, even in the absence of visible pathology of the cervix. There are no contraindications to the procedure, no special preparation is required before colposcopy.
With the help of colposcopy, it is possible to obtain information about the condition of the vaginal mucosa and cervix, identify pathological foci, carry out differential diagnosis of benign changes from malignant ones, conduct a targeted biopsy and swabbing with the greatest informativeness. In a colposcope, you can see even the most minor mucosal defects, erosions, cysts, polyps, warts, endometriosis, inflammatory, precancerous diseases, tumors in the vulva, vagina and cervix, cervical cancer.
Methodology of conducting
Colposcopy is performed on any day of the menstrual cycle (with the exception of menstruation). The study is carried out on a gynecological chair. Due to the non-contact and painlessness of colposcopy, anesthesia during the procedure is not indicated. Colposcopy is performed after exposing the cervix with mirrors and removing the discharge from its surface with a swab. There are simple and extended colposcopy. A simple colposcopy involves examining the cervix at various magnifications using a colposcope without conducting drug tests.
With extended colposcopy, preliminary tests are performed: treatment of the mucous membrane of the cervix with a 3% solution of acetic acid and an aqueous solution of Lugol (Schiller test), followed by examination in a colposcope. Under the action of acetic acid, there is a short-term contraction of the vessels of the mucous membrane and a decrease in blood supply to the tissues of the cervix. This test allows you to see pathologically altered vessels characteristic of precancerous conditions and cervical cancer. The treatment of the cervix with an iodine-containing Lugol solution leads to the staining of the flat epithelium covering the outer part of the cervix in a dark brown color. The affected areas of the squamous epithelium, the so-called iodine negative zones, are not colored and stand out on a dark brown background in the form of white spots.
During colposcopy, the color of the mucosa, vascular pattern, surface and level of the flat epithelium, the presence and shape of the glands, the boundaries of the identified neoplasms (clear or blurred) are evaluated. Colposcopy allows you to identify altered areas of the cervix that cannot be diagnosed with the naked eye during a routine examination. The effectiveness of colposcopic examination is over 80%.