A colposcopy is a well tolerated brief in-office procedure that lasts less than 15 minutes. A speculum is placed in the vagina to visualize the cervix, and the cervix is washed off with a q tip soaked in saline (salt water). This does not hurt at all and will be cold and wet.
Through the colposcope (a microscope specially made for the cervix) we look at the architecture and the blood vessels in the cervix under regular white light and then again under the green filter. We then use acetic acid (regular household vinegar) to wash off the cervix and we again look under the colposcope to see if there are any acetowhite areas that may indicate dysplasia (abnormal cells).
We take a cervical biopsy in the areas that are acetowhite, under direct visualization from the colposcope. A single or multiple biopsies may be taken, depending on what is found on colposcopy. Then an endocervial curettage or ECC is done (except in pregnancy). The endocervix (inside of the cervix) is scraped circumferentially to make sure that the abnormal cells found on the pap smear are not related to a lesion that is occult (hiding) in the endocervix.
Remember that when we take a pap smear we are sampling the outside of the cervix with a spatula or similar instrument, and we are using a brush to obtain cells from the endocervix, so we need to make sure that those atypical cells are not coming from the endocervix where we cannot see.
**Have Questions About Your Gyn Issues? **
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