Colposcopy of the cervix - what is it? When do colposcopy and why

Colposcopy of the cervix - what is it, 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 various pathological conditions of the external genitalia. One of these methods is colposcopy.

What is this method?

Colposcopy and cervical biopsy 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, which would not be equipped with this equipment. The most commonly used method is an advanced colposcopy, which involves examining the mucous surface of the cervix, vagina and vulva by means of a microscope with an enlarged image 30-40 times, carrying out certain diagnostic tests. These tests are based on the ability of the epithelial surface to react differently to the treatment with various medications.

With the help of this method of research, it is possible to more accurately diagnose, evaluate the effectiveness of the treatment performed previously identified pathology. Plus this method is also in the fact that the results of colposcopy of the cervix will be promptly reported to the patient, and she immediately orient to conduct one or another variant of drug therapy.

What influences 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. They include the following:

• Estrogenic or progesterone insufficiency;
• Day of the menstrual cycle (which phase: luteal, follicular or ovulation time);
• At what stage of its development is the inflammatory process;
• Age of the patient.

A big role is played by how to interpret the picture seen, what classification to use. It's no secret that colposcopy is in many ways a subjective method of examination. The same picture doctors can describe in different ways and, accordingly, set different diagnoses. Therefore, it is important before and after treatment to perform a survey from the same doctor. This differs from other colposcopy procedures. What it is, you now understand. It remains to be seen how this procedure is performed, and most importantly, when.

Description of the method

The best time to perform the study is the first phase of the cycle, that is, immediately after the end of bleeding, but before ovulation. In principle, colposcopy can be performed on any day of the cycle. Do not overlook the attention of pregnant women, who may also need to conduct this study. In this case, just do not forget that they have a colposcopic picture will normally be different.

Preparation for colposcopy of the cervix is not needed. It is desirable before this to get the results of smears on oncocytology and microflora. If the analysis shows signs of inflammation, it is better to be treated in advance, because the abundant discharge will interfere with adequately assessing the changes seen in the mucous membrane of the cervix, vagina and vulva.

Stages of colposcopy

So, how do colposcopy of the cervix? The patient in the doctor's office completely undresses from the bottom to the waist and lies down in the gynecological chair. A specialist in the pathology of the cervix, or simply a gynecologist, inserts mirrors into the vagina. A woman needs to be as relaxed as possible, because for the convenience of inspection (to prevent the mirror from turning) take, as a rule, a tool of a slightly larger size than with a normal examination. And in this position the patient is about 15-20 minutes, depending on how much the doctor understands the picture he saw. At the initial stage of the examination, green microscope filters are used, which allow to identify atypically located vessels on the surface of the cervix. This ends the first stage.

Then the gynecologist clarifies whether the woman has any allergic reactions to any medication, and proceeds to the second stage of the examination. The consecutive treatment of mucous membranes is first performed with a weak solution of vinegar, and then with iodine solution. According to the observed reaction of the mucous membranes for 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. Decoding of colposcopy of the cervix can be done immediately if the procedure was performed by the attending physician, or at a subsequent appointment with his gynecologist.

It would be desirable to stop a little on those pathological conditions which can be revealed at carrying out of research.

Nabotovy cysts

On the surface of the cervix there are functional entities such as pseudocysts. When, for some reason, there is a blockage in their exit duct, the secret begins to accumulate inside the cyst. As a result, it increases in size and looks like an education with a whitish or yellowish (when attaching a bacterial infection) shade. There is an expansion of the lumen of small vessels, the development of inflammatory infiltration around the cyst.

Condyloma

When the colposcopy is performed (photos of the cervix infected with infection, the sight is far from the most pleasant), it is possible to identify exophytic condylomas or flat papillomas.

The cause of the appearance of exophytic condylomas is the defeat of human papillomavirus. Usually they rise above the mucous surface, can have a thin leg or, but rarely, a wide base. In color, they range from pale pink to red. Condylomas can be thin or thick, spaced apart or blended into a picture that looks like cauliflower in appearance.

Squamous papillomas are benign, their histological structure differs from the structure of exophytic condylomas. There is no reliable evidence that human papillomavirus is not the cause of their occurrence. With colposcopy, papillomas are visualized as lonely standing formations, which are covered with normal mucosa; the only nuance is the presence of a branched vascular network.

True erosion of the cervix

Colposcopy of the cervix in erosion should be performed regularly. Erosion of the cervix is a defect in the surface of the mucosa, its partial absence. The bottom of the ulcer is represented by a stroma, there may be a granulation component, it can be covered with fibrinous exudate. The cause of ulceration is usually a trauma on the background of the existing atrophy of the integument epithelium, a long inflammatory process, an oncological disease. This colposcopic picture is not normal for women of reproductive age. Iodine does not stain, there is a pronounced red tint. When colposcopy is performed in this situation (photos of the cervix can be obtained from a gynecologist), when staining with a solution of vinegar, the patient may complain of burning in the vaginal area.

Vaginitis

The presence of an inflammatory process makes it difficult to examine because of 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 prior sanation, missed, or vice versa, the conclusion will be shifted to the side of overdiagnosis.

Inflammatory process in the acute period is characterized by a marked reddening of the mucosa, pronounced edema, small-scale rashes, a large number of secretions of various colors. The color and consistency of the product being separated is largely dependent on the microorganism that caused the infectious process.

If the pathological process has a prolonged course without adequate treatment, ulcers can form on the surface of the cervix, vagina or vulva, which lead to the formation of true erosion. Often the bottom of such ulcers is congested.

Who is shown the study "Colposcopy of the cervix"?

What it is, you already know. Now we need to figure out which category of patients this study should perform. Ideally, this survey should be subjected to all 100% of patients who go to see a doctor. But the real situation is that in practice this is not yet possible. If we talk about women's consultations, then in each room there is usually no colposcope, therefore, there is not enough time to complete this type of study (for each patient there is about 15-20 minutes). If we talk about private medical centers, then there are wider opportunities, but there is another problem - 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 colposcopy necessarily, then these are women with the following problems:

• With erosion or ectopia of the cervix;
• Carriers of human papillomavirus;
• Patients after anti-inflammatory treatment, before and after destructive methods of treatment of 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 conducted no more than once a year. In the presence of serious pathology (erosion of the cervix, dysplasia, oncology), the examination is performed once every six months. After carrying out anti-inflammatory therapy, colposcopy should also be performed in order to check the effectiveness of the medication.

Side effects

There was no evidence of any serious consequences after colposcopy. During the study, there may be the same unpleasant sensations as in a normal examination in mirrors. Especially if the patient is tense, and the walls of the vagina abut the edges of the mirror (which in itself does not add pleasant sensations).

If the patient has an allergy to iodine, and the doctor did not find out, an allergic reaction of varying intensity may develop. In the presence of inflammatory process when treated with a weak solution of vinegar, burning 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 it is, now every woman understands) does not lead to any remote negative consequences.

When can not I perform the procedure?

The study is not recommended in the postpartum period. This means that the first two months after the birth of the child should refrain from the passage of this procedure, because there has not yet been a complete restoration of the structure and mucosa of the cervix.

You can not do colposcopy in the first month after the interruption of pregnancy. First, the mucosa is still under the influence of a changed hormonal background. Secondly, spotting that can bother a woman for four weeks will interfere with the procedure.

You can not prescribe a test immediately after a cryodestruction of the cervix or another 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 not yet worthwhile to perform this manipulation? In the following cases:

• During menstruation, when there is bleeding of unclear etiology;
• Started inflammatory process with abundant purulent secretions;
• Significant atrophy of mucous membranes.

conclusions

Colposcopy of the cervix (what it is, understood from the text above) is a safe and inexpensive method that allows to reveal various pathological processes of the cervix, vulva and vagina. This method of investigation practically does not give complications. The rare cases include:

• The appearance or strengthening of bloody discharge;
• Low-grade fever;
• Change in color of discharge (especially after iodine staining).
• Stretching pain in the abdomen immediately after the procedure.

If any of these symptoms persists for more than one day, then this is an occasion to re-apply to the gynecologist. Colposcopy of the cervix, reviews about the procedure are usually positive, with acute need can be performed on any day of the menstrual cycle.