GYN Services
Colposcopy
A colposcopy is a way your doctor can examine your genitals, vagina and cervix more closely. A colposcope is an instrument that shines a light on the cervix and magnifies the view for your doctor. At the beginning of the exam, you lie back and place your feet in the stirrups as you would for a pap smear. Your doctor inserts a speculum into your vagina and opens it slightly so your cervix can be seen. Then your doctor applies a vinegar solution to the cervix and vagina with a cotton ball or swab. The vinegar makes abnormal tissue turn white so your doctor can identify areas that may need further evaluation.
If your doctor sees areas of abnormal tissue during the colposcopy, he or she may also perform a biopsy. This involves removing small samples of tissue from any abnormal areas in or around the cervix. A specialist doctor called a pathologist will examine these samples.
It usually only takes 20 to 30 minutes for your doctor to complete a colposcopy and biopsy.
LEEP
This may be an outpatient procedure in the doctor's office or it may be performed in an operating room. This procedure may be recommended by your doctor if your pap test or other test revealed abnormal cells on your cervix. The LEEP Procedure, otherwise known as Loop Electrosurgical Excision Procedure, removes abnormal tissue/cells from your cervix.
Some abnormal cell growth in your cervix is called dysplasia. Dysplasia is not cancer, however, if left untreated, it may lead to cancer. The LEEP Procedure allows the physician to remove the abnormal tissue and preserves it for further examination so that it may be tested to determine if cancer is present.
Similar to the pap test, you will place your feet into the stirrups and your doctor will insert a speculum into your vagina. The doctor will apply a local anesthetic to your cervix, which will help reduce bleeding and numb the area. A mild vinegar or iodine solution is applied to your cervix to mark any dysplasia. The doctor may use a colposcope to look closely at the area. The colposcope is a piece of optical equipment, which magnifies the area like a microscope.
To remove the abnormal cells (also called dysplasia), a delicate loop of wire with a special high-frequency current is used. The size and shape of this wire loop depends on the location and extent of the abnormal cells. The small size means very little damage is done to the surrounding tissue and the high-frequency current means blood vessels are sealed which decreases bleeding. After the abnormal cells are removed, a medicated paste is applied to the cervix to help reduce bleeding. This paste may cause dark vaginal discharge for a few days after the procedure.
Complications are infrequent but may include:
- Heavy bleeding, possibly with clots
- Severe cramping or abdominal pain
- Incomplete removal of abnormal tissue
- Narrowing of the cervix
- Infection
- Fever
- Foul-smelling discharge
Rare but possible complications include:
- A weakened cervix that could cause problems during pregnancy
- Accidental cutting or burning of normal tissue.
You may feel mild cramps following a LEEP. You may be able to go back to work the same day. If you have discomfort, your doctor may prescribe medication. You will be asked to schedule some follow-up exams.
You may experience some of the following:
- Thick, dark discharge (this is a normal result of the medicated paste used)
- Mild cramping
- Slight vaginal bleeding or watery discharge
- Heavier bleeding during your next period
Talk with your doctor about activities to avoid during recovery. Typically you can return to most of your usual activities. It is important to help your cervix heal by avoiding some activities, such as sexual intercourse, tampons, heavy lifting or vigorous exercise for a few weeks after the procedure.
You will need follow up visits with your doctor to monitor your progress. The first follow up visit is one month after the procedure to have your cervix checked in order to make sure it is healing correctly. Then you will see your doctor once every three months to obtain 3 normal pap tests. Once this series of visits is complete, you will continue your usual annual pap schedule.
