“ I had never had a Cervical Smear before so I was quite nervous. Mr McIndoe was very professional and courteous. He took the time to answer all of my questions and alleviate any doubts I had. He made sure that he understood what I was asking and that I understood what he explained."
A colposcopy test or examination is a careful look at the cervix with a microscope. The colposcope stays outside the body and magnifies the view of the cervix 10 to 20 times. The colposcopy procedure is just like a smear test, although it takes a little longer. Colposcopy should be performed with sensitivity and respect. It need not hurt at all when performed gently without any rush.
What does colposcopy show?
Colposcopy is used to identify any areas of abnormality in the skin of the cervix. A very dilute solution of acetic acid is used to stain the cells of the cervix. With this solution, abnormal skin looks white and may have patterns which allow it to be recognised when compared with healthy skin. A dark brown solution of Lugol’s iodine may also be used. This stains normal skin “mahogony brown” but stains abnormal skin less darkly.
More common questions are answered below.
What is an erosion?
This is an old name for the transformation zone. This is an area surrounding the canal of the cervix, where the delicate skin lining the canal extends onto the outer part of the cervix. It looks red and so has been called an erosion although this appearance is a normal finding. A more modern name for this appearance is an ectropion, reflecting the origin of this appearance.
What is the significance of the transformation zone?
This is the junction between the delicate columnar skin lining the internal parts of the cervix and the tougher squamous skin lining the outer part of the cervix. This area is often called the squamo-columnar junction. This is a very active area of skin where the columnar epithelium is undergoing a process called metaplasia, and changing into squamous skin. When metaplasia goes wrong it becomes dysplasia.
How does colposcopy help in the management of CIN?
Colposcopy allows us to identify abnormal skin on the cervix. Often a biopsy will be taken from any areas of skin that appear abnormal. That biopsy may determine whether treatment is necessary or not.
Is a biopsy always done at colposcopy??
A small sample of the skin of the cervix, about the size of a grain of rice, can be removed and sent to the laboratory for analysis. This is called a biopsy. This may be done on the first visit if a high grade abnormality is present, but is not always necessary for low grade abnormalities or for follow up visits.