Currently, women are increasingly diagnosed with pathologies of the cervix. Moreover, some of them are malignant. For the timely detection of pathological processes, gynecologists prescribe colposcopy. This is an instrumental diagnostic method that allows you to assess the state of tissues and identify various diseases even at an early stage of their development. Colposcopy is usually carried out after receiving a positive result of the study of biomaterial according to Papanicolaou. In addition, it is prescribed to monitor the effectiveness of the treatment.
Colposcopy: concept
This diagnostic method relates to instrumental methods. It is the most commonly prescribed procedure in gynecology. How is colposcopy performed? The study is carried out using special equipment - a binocular microscope equipped with a backlight. This device is called a colposcope.
During the study, the doctor gets the opportunity to assess the structure of the vulvar mucosa, as well as the tissues of the cervix and vagina under a microscope. Advanced diagnostics involves the collection of biological material, which is subsequently sent to the laboratory for histological analysis.
Many women are interested in how colposcopy of the cervix is ​​performed, whether it hurts. It is important to know that this diagnostic method is non-contact. The design of the device is represented by the base, tripod and optical head. Prismatic binoculars with eyepieces are integrated into the latter, allowing detailed examination of any area of ​​the mucous tissue. There is also a illuminator in the optical head. In other words, even in the presence of a pronounced inflammatory process, women do not feel severe pain. Perhaps the appearance of only slight discomfort arising from the introduction of a gynecological dilator.
Colposcopy is usually performed at low magnification. Even with this setup of equipment, it is possible to identify foci of pathology, to evaluate their localization, shape, color, and nature of the surface. If suspicious areas are found, the doctor can examine them at maximum magnification. For better visualization of blood vessels, a specialist uses a green filter during the study. The colposcopy procedure is carried out, as a rule, with an increase in tissue by 6 times. As mentioned above, if necessary, this indicator can be changed upward (up to 40 times).
Indications
A study can be prescribed if the patient has the following alarming symptoms:
- Pain in the lower abdomen.
- Vaginal discharge other than normal.
- Itching and burning of the external genitalia.
- Vaginal bleeding not associated with the period of location.
- Painful sensations and secretions with impurities of liquid connective tissue that occur during intercourse.
Colposcopy of the cervix is ​​carried out, as a rule, after obtaining the results of the study of the urogenital smear according to Papanicolaou. The study is shown in the detection of pathologically altered cells in biological material, the detection of human papillomavirus, suspected development of a malignant disease.
What allows you to identify
With the help of the study, the doctor can detect the following diseases and conditions:
- Inflammatory processes.
- Cervical erosion.
- Precancerous conditions.
- Oncological diseases.
- Endometriosis
- Dysplasia
- Ectopia.
- Leukoplakia.
- Tumors
- Erythroplakia.
- Vascular changes in the mucous membrane.
In addition, with the help of colposcopy, the doctor is able to assess the dynamics of changes during treatment.
What days of the menstrual cycle do you have to study
Colposcopy of the cervix is ​​usually performed in the first half of this period. The ideal option is one in which a woman undergoes a study immediately after the cessation of menstrual bleeding.
It is important to know that with menstruation colposcopy is not performed, like most other diagnostic measures. This is due to the fact that during bleeding it is impossible to provide a good visualization of tissues.
Training
In order for the study to be as informative as possible, some rules must be observed. The doctor during the registration of the direction should explain in detail what colposcopy of the cervix is, how it is performed with erosion, papillomas and other pathologies, how long it takes and what needs to be done to prevent false results.
Rules of preparation:
- For 2 days, you must abandon all kinds of douching.
- For 2 days, you need to stop using products intended for intimate hygiene. It is recommended to wash the external genitalia with ordinary soap.
- A few days before the test, use a condom during intercourse. It doesn’t matter if a woman takes combined oral contraceptives or not.
- For 2 days, you need to abandon sexual intercourse even with a condom.
- For 4-5 days, it is necessary to complete the treatment with the help of suppositories, vaginal tablets and other topical preparations.
Adjustment of diet and physical activity is not required.
How is colposcopy performed: a classic technique
This type of study is prescribed most often. But in advance, the patient is still warned that during the diagnosis process it may be necessary to take biological material for analysis in the laboratory.
How is colposcopy of the cervix uteri performed:
- A woman is placed on a gynecological chair.
- The doctor introduces a dilator into the vagina for the patient to provide the best visualization of the tissues.
- The specialist turns on and sets up the colposcope, directing the rays of light into the studied area.
- A doctor with a small increase examines the vagina and cervical canal. When a large amount of mucus is secreted, it drains the tissue with a cotton swab.
- If foci of pathology are detected, the doctor evaluates their color, surface character, size and shape.
- To assess the vasculature, a specialist examines the tissue through a green filter.
- The doctor turns off the colposcope and removes the gynecological dilator from the patient's vagina.
Conclusion after a standard colposcopy can be obtained in a few minutes. With the results of the study, you should contact your treating gynecologist.
Advanced Diagnostics
This is a type of colposcopy, which is prescribed for suspected serious pathologies. It has several contraindications.
The procedure is not prescribed in the following cases:
- In the presence of individual intolerance to iodine.
- Less than 2 months have passed since the delivery process.
- In the first 30 days after abortion.
If there are contraindications, a classic colposcopy can be performed that does not imply the use of reagents.
It is important to know that with the development of a pronounced inflammatory process, the appearance of painful sensations is possible. They can occur during contact between tissues and the reagent.
How is colposcopy of the cervix uteri performed:
- The procedure begins with the placement of a woman on a gynecological chair.
- The doctor inserts mirrors into the patient's vagina. After that, the specialist performs an initial examination (the algorithm for conducting classical colposcopy is described above).
- The doctor moistens the swab in an aqueous-vinegar solution. After that, he treats them with the mucous membrane.
- After 2-3 minutes, the doctor evaluates the result. If a vasospasm occurs, the vinegar sample can be considered positive. If it is absent in any area, it is customary to talk about the presence of atypical cells. In this case, the sample is considered negative.
- The doctor is preparing a new solution. It is represented by water, iodine and potassium iodine. Proportions - 100: 1: 2. If the entire area of ​​the mucosa has turned brown, this indicates the absence of pathologies. With uneven pigmentation, it is customary to talk about the development of the disease. In this case, the foci of pathology have clear boundaries.
- In the presence of atypical sites, the collection of altered cells is carried out. During the biopsy, the doctor cleaves a small piece of tissue (no more than 2 mm) and sends it to the laboratory.
The duration of an extended colposcopy is, on average, 15-20 minutes.
Pregnancy
The period of bearing a child is not a contraindication to the diagnosis. In early pregnancy, colposcopy is prescribed in order to confirm or exclude the pathology, suspicions of which appeared after receiving bad or doubtful results of a smear from the cervix for oncocytology. In this case, with the help of the study, it is possible to identify the disease in a timely manner and determine the further management tactics of the patient.
In most cases, pregnant women are prescribed classic colposcopy. An expanded type of study is carried out only in case of emergency.
Interpretation of Results
After the study, the specialist draws up a conclusion. Deciphering the results should only be done by the attending physician. This is due to the fact that self-interpretation can lead to erroneous conclusions.
As a rule, the following indicators are reflected in the conclusion:
- The length of the cervix. In a healthy woman, she is about three centimeters.
- The shape of the external pharynx. The opening of the cervical canal can be slit-like (after natural birth), punctate (in nulliparous) and have cicatricial changes.
- Flat epithelium. Normally, it has a smooth surface and a pale pink color.
- Cylindrical epithelium. Normally, it should be only inside the cervical canal.
- Transformation Zone. She may be barely visible on examination. Sometimes it is not visualized.
If pathological foci are detected, the conclusion shall indicate their shape, size, color and surface character.
What rules should be observed after the procedure
Immediately after the diagnostic measures, a woman can begin to carry out her daily activities. The first 2 days it is recommended to use daily pads. This is due to the fact that after colposcopy, the appearance of secretions is possible.
Other recommendations of doctors:
- If biomaterial was taken, it is forbidden to take baths, visit baths and saunas during the next 10 days. In addition, you can not use tampons, have sex, douche and take drugs that contain aspirin.
- After the procedure, there is a risk of complications, for example, vaginitis or an allergic reaction to iodine. With satisfactory well-being, these conditions are not an occasion to consult a doctor.
If spotting has not stopped during the day, you must come to a medical facility as soon as possible. Purulent discharge, fever, pain in the lower abdomen, dizziness - these conditions are also an occasion for immediate medical attention.
Reviews
Colposcopy is a procedure that is easily tolerated by most patients. Due to its informational content, it has a huge number of positive reviews. Colposcopy of the cervix is ​​carried out, as a rule, with suspected development of a pathological process. However, even with severe inflammation, patients do not experience severe pain.
Finally
After receiving bad or doubtful smear test results, the gynecologist prescribes colposcopy. This is an instrumental diagnostic method that allows you to assess the state of tissues under an increase of 6-40 times. When drawing up a referral, the doctor provides information on how colposcopy is performed, how a biopsy is done (if necessary) and voices the rules of behavior after medical manipulations.