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Colposcopy - directed biopsy

Alternative names

Biopsy - colposcopy-directed


A colposcopy-directed biopsy is performed using a colposcope to aid in the viewing of the surface of the cervix . It also helps to identify areas on the surface which show tissue abnormalities. A colposcope is a low-power microscope used to magnify the surface of the cervix 10 to 40 times its normal size (see also " Cervical biopsy ").

How the test is performed

As in a regular pelvic examination, you will be asked to lie on your back with your feet in the stirrups. A speculum (an instrument used to hold open the birth canal in order to view and examine the cervix ) will be inserted into your vagina and opened slightly.

The cervix is then swabbed with a chemical solution (acetic acid) to remove the mucus that covers the surface and help highlight abnormal areas. The colposcope is then positioned at the opening of the vagina, and the area is thoroughly examined. Photographs may be taken.

Any abnormal areas will have a small sample of the tissue removed ( biopsy ) using small biopsy forceps. Many samples may be taken, depending on the size of the area.

How to prepare for the test

There is no special preparation. The procedure may be more comfortable if you empty your bladder and bowel beforehand. You should not douche or have sexual intercourse for 24 hours before the exam.

How the test will feel

A colposcopy is painless. Some women feel a slight stinging sensation caused by the vinegar solution. The biopsy may feel like a pinch each time a tissue sample is taken and may have some cramping with it.

Any pain or cramping occurring during the biopsy may be helped by relaxing and taking a few slow deep breaths. Some cramping may occur after the biopsy. Many women have a tendency to hold their breath during pelvic procedures in anticipation of pain. Making an effort to concentrate on slow, regular breathing will help you relax and reduce or eliminate some pain.

Why the test is performed

This is usually performed after a positive pap smear to help identify the abnormality.

Normal Values

A smooth, pink surface of the cervix is normal. A biopsy is only performed when abnormal tissues are seen or suspected because of abnormal pap smear results.

What abnormal results mean

Abnormalities detected include cervical warts ( human papilloma virus ), precancerous tissue changes, cervical intraepithelial neoplasia (tumor) , or invasive carcinoma ( cancer ). The colposcopy may be used to keep track of precancerous abnormalities and look for recurrent abnormalities after treatment.

Abnormal findings during a colposcopy include abnormal patterns in the blood vessels, whitish patches on the cervix , and areas that are inflamed, eroded, or atrophic (tissue wasting away). Any of these abnormalities may indicate cancerous changes.

Additional conditions under which the test may be performed:
  • Cervical dysplasia (indicated by abnormal Pap smear )

What the risks are

After the biopsy , there may be some bleeding for up to a week. Avoid sexual intercourse, douching, and using tampons, for 2 weeks to allow the biopsy area to heal.

If bleeding is unusually heavy or lasts for longer than 2 weeks, or if you notice any signs of infection (fever, foul odor, or discharge), your health care provider should be contacted.

Special considerations

When the colposcopic examination or biopsy does not show why the pap smear was abnormal, a more extensive biopsy may be suggested (see Cold knife cone biopsy ).

Update Date: 2/5/2002

Peter Chen, M.D., Department of Obstetrics & Gynecology, University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network.

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Last updated: Tue, 06 Jan 2009 00:20:03 GMT