A colposcopy is indicated in the setting of an abnormal pap smear.  If your pap smear showedatypical cells of undetermined significance(ASCUS) with the presence of human papilloma virus, low grade squamous intraepithelial neoplasia (LSIL), or high grade squamous intraepithelial neoplasia you will be scheduled for a colposcopic examination.  A colposcope is used to enlarge the cervix, and vaginal skin and labia if needed, so that your provider can better visualize potentially abnormal areas.  A special solution called acetic acid is applied to the cervix which assists in visualizing areas of concern.  If an area is identified, a biopsy will be taken to send to a pathologist for more accurate diagnosis.  The goal of the procedure is to obtain a tissue sample if abnormal areas are identified because the tissue will aid the pathologist to make a more accurate diagnosis of the type of abnormal cells that exist than a pap smear alone.

The procedure is performed in the office.  You will be placed in the same position as when you had a pap smear and a speculum will be placed inside the vagina.  The colposcope will be placed just outside, but not touching, the vagina.  If a biopsy is indicated you will be notified.  A special instrument is used to remove a less than 1 mm piece of tissue from the cervix.  During the biopsy you will feel some mild cramping which should resolve within 1-3 minutes.  Often times, the inside of the cervical opening will need to be sampled as well with a special instrument called an endocervical curettage (ECC).  You should abstain from placing anything in the vagina or intercourse for at least three days prior to the procedure and for up to three days after the procedure.  If you start your period prior to the procedure, it should be rescheduled.