Colposcopy of the cervix uteri - what it is, when this procedure is performed and why, will be discussed in this article. Currently, the percentage of women who suffer from various inflammatory (and not only) diseases of the cervix, vagina and vulva has increased. In the arsenal of a gynecologist there are simple and inexpensive methods for diagnosing a variety of pathological conditions of the external genital organs. One of these methods is colposcopy.
What is this method?
Colposcopy and biopsy of the cervix are inexpensive, and most importantly, highly informative methods for diagnosing the pathology of the cervix, vagina or vulva. In modern practice, it is impossible to imagine a gynecologist's office that would not be equipped with this equipment. The most commonly used method is extended colposcopy, which includes examining the mucous surface of the cervix, vagina and vulva through a microscope with an image magnification of 30-40 times, conducting certain diagnostic tests. These tests are based on the ability of the epithelial surface to respond differently to treatment with various medications.
Using this research method, you can more accurately diagnose, evaluate the effectiveness of the treatment of previously identified pathology. The advantage of this method also lies in the fact that the results of colposcopy of the cervix will be promptly reported to the patient, and she will immediately be guided to carry out one or another variant of drug therapy.
What affects the result of colposcopy?
The nature of the data obtained during the examination can be influenced not only by the type of microorganism that led to the development of the inflammatory process, but also by many other factors. These include the following:
- estrogen or progesterone deficiency;
- the day of the menstrual cycle (which phase: luteal, follicular or the moment of ovulation);
- at what stage of its development is the inflammatory process;
- patient age.
An important role is played by how to interpret the picture seen, what classification to use. It's no secret that colposcopy is largely a subjective method of examination. Doctors can describe the same picture in different ways and, accordingly, make different diagnoses. Therefore, it is important to perform an examination with the same doctor before and after treatment. This differs from other colposcopy procedures . What is it, you now understand. It remains to figure out how this procedure is performed, and most importantly, when.
Method Description
The best time to complete the study is the first phase of the cycle, that is, immediately after the end of bloody discharge, but before ovulation occurs. In principle, colposcopy can be performed on any day of the cycle. Do not ignore pregnant patients who may also need to conduct this study. In this case, just do not forget that their colposcopic picture will normally differ.
Preparation for colposcopy of the cervix is not needed. It is advisable to obtain smear results on oncocytology and microflora before this. If, according to the analysis, there are signs of inflammation, it is better to be treated in advance, because copious discharge will interfere with adequately assessing the seen changes in the mucous membrane of the cervix, vagina and vulva.
Colposcopy stages
So how do colposcopy of the cervix do? The patient in the doctor’s office completely undresses from the bottom to the waist and lays down in the gynecological chair. A specialist in cervical pathology, or simply a gynecologist, inserts mirrors into the vagina. A woman needs to be as relaxed as possible, because for the convenience of the examination (so that the mirror does not spin), as a rule, they take a tool of a slightly larger size than during a normal examination. And in this position the patient is about 15-20 minutes, depending on how much the doctor understands what he saw. At the initial stage of the examination, green microscope filters are used to identify atypically located vessels on the surface of the cervix. This is where the first stage ends.
Then the gynecologist checks whether the woman has allergic reactions to any medication, and proceeds to the second stage of the examination. A sequential treatment of the mucous membranes is carried out, first with a weak solution of vinegar, and then with a solution of iodine. According to the reaction of the mucous membranes to staining, a specialist can identify suspicious foci and direct the patient to a biopsy.
When the examination is completed, the doctor removes the mirror from the vagina, and the woman goes to dress. Decryption of colposcopy of the cervix can be carried out immediately if the procedure was performed by the attending doctor, or at a subsequent appointment with your gynecologist.
I would like to dwell a little on those pathological conditions that can be identified during the study.
Nabotov cysts
On the surface of the cervix there are such functional formations as pseudocysts. When for some reason there is a blockage in their outlet duct, the secret begins to accumulate inside the cyst. As a result, it increases in size and looks like a formation with a whitish or yellowish (with the attachment of a bacterial infection) hue. There is an expansion of the lumen of small vessels, the development of inflammatory infiltration around the cyst.
Condylomas
When colposcopy is performed (a photo of the cervix infected with an infection, the sight is far from the most pleasant), exophytic condylomas or flat papillomas can be detected.
The cause of the appearance of exophytic condylomas is the defeat of the human papilloma virus. Usually they rise above the mucous surface, can have a thin leg or, but less commonly, a wide base. In color, they range from pale pink to red. Condylomas can be thin or thick, individually located or merge into a picture that looks like cauliflower.
Squamous papillomas are benign formations, their histological structure differs from the structure of exophytic condylomas. There is no reliable evidence that the human papillomavirus is not the cause of their occurrence. With colposcopy, papillomas are visualized as lonely standing formations that are covered with normal mucosa, the only nuance is the presence of a branched vascular network.
True cervical erosion
Colposcopy of the cervix during erosion should be performed regularly. Cervical erosion is a mucosal surface defect, its partial absence. The bottom of the ulcer is represented by the stroma, a granulation component may be present, and may be covered with fibrinous exudate. The cause of ulcer formation is usually trauma against the background of existing atrophy of the integumentary epithelium, a long inflammatory process, and cancer. This colposcopic picture is not normal for women of reproductive age. Iodine staining does not occur, there is a pronounced red tint. When colposcopy is performed in this situation (a photo of the cervix can be obtained from a gynecologist), when stained with a solution of vinegar, the patient may complain of a burning sensation in the vagina.
Vaginitis
The presence of the inflammatory process significantly complicates the examination due to the large number of secretions, while the colposcopic picture can be misinterpreted. The inflammatory process is common or localized. If there is a pathology of the cervix, colposcopy can be performed without preliminary debridement, skipped, or vice versa, the conclusion will be shifted towards overdiagnosis.
The inflammatory process in the acute period is characterized by a noticeable redness of the mucosa, severe swelling, small-point rashes, a large number of secretions of various colors. The color and consistency of the discharge largely depends on the microorganism that caused the infectious process.
If the pathological process has a long course without adequate treatment, then ulcerations can form on the surface of the cervix, vagina or vulva, which lead to the formation of true erosion. Often the bottom of such an ulcer is pus-like.
Who is shown the study "Colposcopy of the cervix"?
What it is, you already know. Now you need to figure out which category of patients this study should be performed. Ideally, all 100% of patients who are admitted to the doctor should undergo this examination. But the real situation is that in practice this is not yet possible. If we talk about women's consultations, then in each office there is usually no colposcope, therefore, there is not enough time to perform this type of study (about 15-20 minutes are allocated for each patient). If we talk about private medical centers, then there are wider opportunities, but another problem arises - insufficient financial security of the population. Not every woman can afford to undergo a full examination for her money.
If we talk about risk groups - those who need to undergo colposcopy necessarily, then these are women with the following problems:
- with erosion or ectopy of the cervix;
- carriers of the human papillomavirus;
- patients after anti-inflammatory treatment, before and after destructive treatments for cervical pathology;
- patients with atrophic vulvovaginitis;
- pregnant women.
How often is colposcopy performed?
If the patient has no pathology of the cervix, vagina or vulva, then the study is carried out no more than once a year. If there is a serious pathology ( cervical erosion , dysplasia, oncology), the examination is performed once every six months. After anti-inflammatory therapy, colposcopy should also be performed in order to monitor the effectiveness of the drug treatment.
Side effects
No serious consequences were noted after colposcopy. During the study, there may be the same unpleasant sensations as with a routine examination in the mirrors. Especially if the patient is stressed, and the walls of the vagina abut against the edges of the mirror (which in itself does not add pleasant sensations).
If the patient is allergic to iodine, but the doctor has not found out, then an allergic reaction of varying degrees of intensity may develop. In the presence of an inflammatory process, when processing with a weak solution of vinegar, a burning sensation in the vagina can be observed. The severity of these symptoms depends on the threshold of pain sensitivity of each particular woman. Colposcopy of the cervix (what every woman now understands) does not lead to any long-term negative consequences.
When is the procedure impossible?
The study is not recommended in the postpartum period. This means that the first two months after the birth of a child should refrain from undergoing this procedure, because the complete restoration of the structure and mucous surface of the cervix has not yet occurred.
You can not do colposcopy in the first month after an abortion. Firstly, the mucosa is still under the influence of a changed hormonal background. Secondly, spotting that may bother a woman for four weeks will interfere with the procedure.
You can not appoint an examination immediately after cryodestruction of the cervix or other type of surgical treatment. Because in this situation, the process of regeneration and epithelization of the damaged surface may not yet be completely completed. When is it still not worth carrying out this manipulation? In the following cases:
- during menstruation, when bleeding of an unclear etiology occurs;
- advanced inflammatory process with copious purulent discharge;
- significant mucosal atrophy.
findings
Colposcopy of the cervix (what it is, understood from the above text) is a safe and inexpensive method that allows you to identify a variety of pathological processes of the cervix, vulva and vagina. This research method has virtually no complications. Rare cases include:
- the appearance or intensification of spotting;
- low-grade fever;
- discoloration of the discharge (especially after application of iodine staining).
- drawing pains in the lower abdomen immediately after the procedure.
If any of these symptoms lasts more than one day, then this is an occasion to contact a gynecologist again. Colposcopy of the cervix, reviews of the procedure are usually positive, in case of urgent need can be performed on any day of the menstrual cycle.