Because the Pap smear is a screening tool and not a diagnostic tool, your gynecologist may want to take a closer look at your cervix to determine the cause of your abnormal Pap smear results. He will perform an examination called a colposcopy. Your doctor may order this procedure if you have Pap smear results which:
- indicate dysplasia or cancer
- show evidence of HPV
- show atypical squamous cells of undetermined significance (ASCUS) or repeated (ASCUS)
Your gynecologist may also order a colposcopy because your cervix appears abnormal during your pelvic exam and Pap smear, or if you have a history of prenatal DES exposure.
Colposcopy is a simple and painless procedure performed in a gynecologist's office that takes 10 to 15 minutes. You are positioned on the examination table like you are for a Pap smear, and an acetic acid (such as common table vinegar) is placed on the cervix. This causes the cervical cells to fill with water so light will not pass through them.
Your physician will use a colposcope to view your cervix. A colposcope is a large, electric microscope that is positioned approximately 30 cm from the vagina. A bright light on the end of the colposcope lets the gynecologist clearly see the cervix.
During the colposcopy, the gynecologist focuses on the areas of the cervix where light does not pass through. Abnormal cervical changes are seen as white areas -- the whiter the area, the worse the cervical dysplasia. Abnormal vascular (blood vessel) changes are also apparent through the colposcope. Typically, the worse that the vascular changes are, the worse the dysplasia.
If your physician can view the entire abnormal area through the colposcope, a tissue sample or biopsy is taken from the whitest abnormal areas and sent to the lab for further evaluation.
Source:
ACOG Patient Education Pamphlet AP135. Colposcopy. http://www.acog.org/publications/patient_education/bp135.cfm. Accessed 07/14/09.
