How does colposcopy of the cervix occur? Colposcopy - “I share my experience of four colposcopies, one of which with a biopsy. Recommendations on how to prepare." Medical equipment used

Colposcopy is a method of visualizing the cervix. Currently, it is considered non-invasive and does not pose a threat to life or further progression of possible pathology.

It should be done using a special device - colposcope. It is a device with a magnifying device and lenses.

In most cases it does not take more than 20 minutes. Due to the ease of implementation, it is performed even on an outpatient basis.

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What is the cervix?

Cervix- This is one of the constituent parts of the female genital organs. It is not only an important functional, but also an anatomical element. This is primarily due to the presence of cellular composition.

In the area of ​​the cervix there is a junction of several epithelial layers at once. Among them, the main ones are stratified squamous epithelium and columnar epithelium. The joint can be located in different parts of the cervical canal.

The cervix has a cylindrical shape, the dimensions should reach 3-4 cm in length. Its structure is homogeneous, without additional inclusions, and has a dense elastic consistency.

The cervix is ​​divided into two main sections:

1. External os. The external os is that part of the cervix that is the border with the vaginal cavity.
2. Internal os. The internal os is the area that communicates with the uterine cavity.

Another component of the cervix is cervical canal, it is precisely this that is the communication cavity of the external and internal genital organs. It is through this area that infection and sperm can penetrate, and the fetus can also pass through at birth.

The cervical canal is the cavity in which epithelium meets in different areas. Normally, it is filled with thick mucus, which serves as a protective barrier.

Why is colposcopy done?

Purposes of the procedure:

• In some cases, colposcopy may be a preventative examination of the cervix.
• Also, an indication for colposcopy is the diagnosis of various types of pathologies, both inflammatory and those associated with a violation of the cellular composition.
• Diagnosis of malignant pathologies is also one of the indications for colposcopy.
• For the purpose of control after treatment.

Indications for colposcopy

Colposcopy is prescribed in the following cases:

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Contraindications for carrying out

Colposcopy- This is a non-invasive method and carries a small number of side effects. Among all contraindications, there are two main groups, including absolute and relative.

Relative

Relative side effects represent temporary removal from the procedure. This is due to the fact that at the moment the result obtained may not be sufficiently informative and lead to deliberately false results. After eliminating this factor, the procedure can be performed.

These include:

Absolute

Currently, absolute contraindications to colposcopy are:

• Cases of allergic reactions to any substances from the constituent components of the reagents.
• Adhesions in the vaginal area, preventing the removal of the cervix.
• Conducting radiation therapy to the lesion.

What does colposcopy show?

Every woman needs to remember that colposcopy is not the final conclusion of the diagnosis. It can only serve as an additional diagnostic measure for subsequent invasive procedures.

Diseases:

• Consequence of the inflammatory process.
• Development of dysplastic changes.
• Suspicion of an oncological process.
• The presence of space-occupying formations, such as condylomatous growths.

There are two types of epithelium, based on changes in which the condition of the cervix is ​​assessed:

• Cells of stratified squamous epithelium. These are cells that in their structure belong to epithelial tissues. They normally cover areas such as the vagina, as well as the outer part of the cervix. During extended colposcopy, these cells are not stained with iodine or vinegar.
• Cells of the glandular epithelium or, as it may also be called, columnar epithelium. Normally, these are cells of the mucous membranes located in the area of ​​the uterine cavity and internal pharynx.

Much attention is paid to the junction of these sections.

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Types of colposcopy

Currently, there are several types of colposcopy, they differ in the technique of execution, as well as the possibility of visualizing pathology.

Simple colposcopy

There are two types:

1. Non-targeted colposcopy which is performed during a routine vaginal examination. In this case, when examining the vagina and cervix, you can evaluate the integrity of the mucous membrane, its color, estimated size, as well as the condition of the external pharynx. In this case, we can only assume the presence of a possible pathology, take biological material for examination, and also outline a plan for further examination and management.
2. Targeted simple colposcopy. It is performed, as a rule, during an examination when pathological elements are detected that may alert to the presence of pathology. Most often, this is the initial stage of performing an extended colposcopy. To do this, the cervix is ​​exposed in the speculum and is processed to remove mucus and discharge from the canal or vaginal cavity. In this case, the area can be observed under magnification. This makes it easier to distinguish or refute the presence of pathology. If pathological elements are detected, then a simple colposcopy will transition to an extended one.

Extended colposcopy

This type of colposcopy is performed using any type of colposcope.

In this case, a distinctive feature is the use of special reagents:

1. Initially, a solution of acetic acid is applied to the cervix without unnecessary impact. in a small concentration.
2. Inspection can be carried out within a certain period of time until the exposure time is up. As a rule, this time does not exceed 3 minutes.
3. After this, without cleansing the cervix, Lugol's solution is applied to it. It contains iodine, which penetrates the surface cells of the mucous membrane.

Preparation for the procedure

Typically, performing a colposcopy does not require any significant preparation. But for the reliability of the data obtained, you should prepare and adhere to several rules regarding lifestyle, care, etc. on the days of the upcoming appointment.

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Such measures can lead to disruption of the integrity of the mucous membranes of the cervix, which will obviously cause a false result.

Among them are:

When is the procedure performed?

1. The study should be carried out any day, especially if there is a suspicion of an oncological process, as well as acute complaints from the cervix.
2. Colposcopy is most informative in the initial days of the menstrual cycle, but there should be no discharge from the genital tract. The optimal time is considered to be 7-10 days of the menstrual cycle.
3. If there is a suspicion, colposcopy should be performed on the 10-15th day of menstruation.
4. During pregnancy, colposcopy can be performed at any time.
5. During menopause, colposcopy is also performed at any time, in the absence of contraindications.

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Conducting a survey

Colposcopy is performed on an outpatient basis, usually in any gynecological department or antenatal clinic. A prerequisite for compliance is the sterility of the room.

Examination stages:

Colposcopy during pregnancy

Many women at the stage of pregnancy planning may be faced with such a question that the doctor prescribes a colposcopy.

Due to their condition, many are afraid of having it performed, believing that it can harm the fetus or cause miscarriage, as well as premature birth.

In fact, in some cases a colposcopy will be absolutely necessary:

• Most often, it is prescribed without fail to women at various stages of pregnancy if a malignant process is suspected. This is usually carried out after the woman registers and receives treatment. In such a case, colposcopy allows you to assess the condition of the cervix, as well as exclude a possible malignant process.
• In addition, when there are complaints about the appearance of bloody discharge and the absence of pathology on the part of the fetus, as well as the presence of pronounced defects in the mucous membrane of the cervix, some doctors begin to confuse it with the physiological state of deciduosis. Outwardly, it may resemble an erosive defect or the presence of multiple papilomatous formations, which begin to bleed upon contact with instruments. Normally, deciduosis goes away in a woman some time after the birth of the child.

The procedure is carried out using a standard algorithm of actions. It is no different from what is performed on women outside of this condition. Standard reagents are applied to the cervix, which contribute to the staining of the cellular composition.

Colposcopy of a pregnant woman should only be performed by an experienced specialist, as in some cases it may be difficult to see it in the mirror. In most cases, it turns out to be harmless to the woman and the fetus.

Contraindications during pregnancy

• There is a risk of miscarriage or the woman has complications during pregnancy.
• The condition of isthmicocervical insufficiency or obvious threat deserves special attention.
• You should also refrain from performing it in cases where allergic reactions to the components of the reagents are detected, as this can lead to a deterioration in the woman’s condition and require the administration of medications.

Consequences

Currently, the design of the devices and the solutions used are safe for use in women, so the risk of complications or side effects is minimal.

Only in extremely rare cases may situations arise that will lead to complications in carrying out this manipulation.

Among them are:

Decoding the results

Results in gynecology may be as follows:

• 
  . This is a condition that is characterized by the fact that the cylindrical epithelium extends beyond the cervical canal, moving to the vaginal part of the cervix. This condition may be congenital and does not always require treatment. In some cases, it may go into the uterine cavity on its own after the birth of the child.
  Normally, it can appear after the use of oral contraceptives, as well as during pregnancy or adolescence.
• Presence of acetowhite epithelium. This is a condition in which the cervical epithelial cells change color to white. More often it characterizes the condition of dysplasia or viral infection. An area of ​​bright white discoloration is found on the cervix. This condition requires mandatory further examination and treatment. A mandatory laboratory test is to identify the human papillomavirus.
• 
  Presence of iodine-negative areas. When performing colposcopy and using Lugol's solution, the exocervix is ​​incorrectly stained in a light color, compared to nearby dark areas. Characterize dysplastic conditions, as well as the phenomena of atrophy and leukoplakia. To clarify the diagnosis in this case, a mandatory biopsy is required.
• Presence of atypical vessels. During the examination, a violation of changes in the vascular pattern is noted; they can not only have a characteristic appearance for any disease, but also a violation of the reaction to the use of reagents.
• Mosaic and punctuation detection. Such conditions characterize the manifestations of vascular pathology. Moreover, they can occur with viral carriage, as well as long-term inflammatory diseases and a possible malignant process.
• Identification of cystically dilated glands. Formations represented by changes in surface cellular elements associated with hormonal imbalances. Most often, the use of conservative therapy is sufficient.
• . A condition that is associated with increased production of epithelial cells. As a result, an area of ​​increased keratinization is observed. This is a variant of the pathology, since normally the cells of the mucous membrane should not become denser. Leukoplakia requires a mandatory biopsy.
• . The appearance of areas of horny epithelium, which can extend beyond the mucous membrane. Most often they resemble cabbage-shaped formations that can reach large sizes. In some cases, it manifests itself as bleeding or the development of infertility. They require effective antiviral treatment and removal of emerging lesions.

What should you not do after a colposcopy?

If colposcopy was performed in an extended version, then no special recommendations are required after it is performed. The woman can go home, minor discomfort is acceptable.

After the procedure, it is recommended to carry out hygienic measures, since acetic acid and iodine solution can cause discomfort, an unpleasant odor and a slight burning sensation if there are defects in the mucous membrane in the vagina and vulva.

If the procedure was performed with a biopsy:

Cost of the procedure

This question will largely depend on the location of the colposcopy.

If the procedure is carried out in the antenatal clinic department or in any hospital of a state medical institution, regardless of the main profile (in most cases this is a gynecological department, but it can also be an obstetric department, as well as an oncology clinic), then as a rule the woman does not pay anything for it. funds.

If colposcopy is performed in a private medical center or commercial department, the price of the procedure. will depend on the level of the institution and the approximate pricing policy.

On average the cost is 500-2000 rubles. It does not depend on the indication for which a woman is sent for colposcopy, as well as her current condition.

The widespread prevalence of diseases of the female reproductive system leads to the use of various diagnostic procedures, one of which is colposcopy. Why is colposcopy needed? This is a minimally invasive method of examining the cervix and vaginal part of the uterus, allowing one to identify diseases in this localization. The procedure is performed using a special colposcope on an outpatient basis or in a medical hospital. Colposcopy is prescribed for suspected cervical disease, as well as for monitoring the condition of the mucous membrane during treatment.

Regular colposcopy allows you to detect pathology at an early stage

General description of the method

A similar procedure can detect various lesions of the cervix and vaginal part of the uterus in women. Hysteroscopy is performed using a special optical system called a colposcope. A hysteroscope is a special binocular with interchangeable eyepieces of varying magnification. In addition, there is a built-in lighting device that allows you to illuminate the mucous membrane during the examination process.

What is colposcopy in gynecology? This is a modern and highly effective way to diagnose diseases of the female genital organs.

Such an optical system allows a gynecologist to conduct a visual examination of the condition of the mucous membrane and diagnose a wide range of diseases without serious invasive interventions. The resulting image can be displayed on a computer screen and also be recorded in its memory for subsequent study or to analyze the effectiveness of treatment.

Indications for examination

Colposcopic examination is performed only if women have appropriate indications for the procedure and there are no contraindications. Indications include the following situations:

• Suspicions of benign or malignant neoplasms in the vagina and cervix, as well as precancerous processes.
• Identification of ectocervix foci and their nature.
• The need for a biopsy for subsequent morphological analysis and selection of treatment.
• The need to choose treatment tactics and additional diagnostic procedures.

In all these cases, colposcopy provides important information for the gynecologist and can be recommended for widespread use. However, it is always necessary to remember about contraindications that limit the use of this diagnostic method. In what cases should this examination method be abandoned?

• Recent history of childbirth (less than 4-10 weeks ago).
• If a woman has undergone destructive or surgical treatment for cervical erosion, etc.
• Based on previous studies, intolerance to a solution of iodine and acetic acid was revealed.

If a woman has indications for colposcopy, but there are also contraindications, then the method should be abandoned, choosing other methods of examination.

Types of colposcopy and their implementation

Colposcopy can be simple or extended

It is very important that the patient knows the answer to the question, how is colposcopy done and why is it necessary to undergo it? This allows you to properly organize preparation for colposcopy, as well as reduce the level of stress during it.

If a woman has female complaints and has never undergone any examinations or tests, then colposcopy is the method of choice for diagnosing diseases.

All types of colposcopy can be divided into two large groups: diagnostic and therapeutic. In this case, during a diagnostic examination, the doctor:

• visually examines the condition of the cervix;
• evaluates its surface;
• external os;
• border between epithelia;
• and also studies discharge from the cervical canal, if any.

The examination does not go deeper than the external os of the cervix. After such an external examination, it is necessary to do an extended colposcopy.

Colposcopy is a completely painless procedure

The procedure is as follows: the cervix is ​​treated with a weak solution of acetic acid (no more than 3%) and changes in the epithelium are assessed. This solution leads to a slight swelling of cells in the mucous membrane and swelling of the epithelium, which reduces blood flow in the submucosal vessels. After this, a Schiller test should be performed using Lugol's solution, which is applied to the surface of the cervix using a cotton-gauze swab. Identified cells with glycogen in their composition can serve as an indicator of affected areas and serve as a guide for a biopsy.

If it is necessary to conduct a vital microscopic examination using a colposcope, preliminary staining of the cervical epithelium with a hematoxylin solution is prescribed, which makes it possible to identify individual cells and their structures. What does colposcopy show in this case? The gynecologist has the opportunity to evaluate individual cells and identify signs of atypia (increased nuclear size, pathological mitoses, etc.), which may indicate the onset of malignant growth.

Colposcopy is highly informative. The coincidence of such an examination with subsequent histological examination is observed in more than 98% of cases, which is a very high indicator of the accuracy of the diagnosis. To increase the specificity and sensitivity of this method, special yellow and green filters can be used to improve the resulting image.

Results

Ectopic columnar epithelium

After a woman has received an answer to the question of how colposcopy is performed, it is very important to understand how to correctly interpret the results and who can do it.

Compliance with the rules and technique of performing the procedure allows you to prevent the development of complications and significantly increase the information content.

This method of examining the female reproductive system allows you to quickly identify endometriosis, endocervicitis, precancerous and oncological lesions of the cervix, as well as polyps and warts on the surface of its epithelium. If the epithelium has a normal structure, then this area is externally distinguished by a light pink tint of color, smoothness and shiny surface. When carrying out Lugol's staining, all cells acquire a brown color, which is associated with the deposition of glycogen in them.

Among the pathological processes, leukoplakia (the appearance of areas of keratinization of epithelial cells), atypical blood vessels, areas of tumor and precancerous transformation of cells can be identified. Such findings serve as an indication for a biopsy and other additional diagnostic methods.

Upon completion of colposcopy

Discomfort in the lower abdomen after colposcopy

Immediately after the end of the diagnosis, a woman may experience discomfort, pain and minor bleeding from the vagina for one to two days, which is associated with minor damage to the mucous membrane. During this period, it is recommended to refrain from sexual intercourse, douching and tampons. If symptoms do not go away within 2-3 days or become severe, you should immediately seek medical help.

What is colposcopy and how is it done? This is a highly informative, minimally invasive method of examining the cervix, widely used in gynecology to identify diseases at the earliest stages of their development. Such a study should always be carried out after consultation with the attending physician, defining indications and contraindications, and only in a special office.

Often, representatives of the fair sex, when faced with the need to perform calposcopy, experience a feeling of anxiety associated with a lack of knowledge about this study.

You can learn about what colposcopy shows in this short article. There is also a corresponding video here that explains in detail how colposcopy is done and why.

What is colposcopy?

Colposcopy is a special type of diagnosis, which is carried out for the purpose of a comprehensive examination of the vagina and cervix using a unique optical device - a colposcope (binocular), equipped with small mirrors and a lighting element. The procedure is characterized by painlessness and ease of implementation.

There are several ways to conduct research, each of which has its own characteristics.

How is colposcopy performed?

First, the specialist can ask the patient a series of simple questions in the form of a short survey. Next, the woman takes off her clothes below the waist and lies comfortably on a special couch. You should try to relax to avoid cramps in the legs. The gynecologist then places the colposcope 10–17 centimeters from the entrance to the vagina.

Access to the cervix is ​​gained by carefully inserting a plastic or metal dilator. The mucous membrane is examined, but the colposcope is not inserted inside. The procedure lasts approximately 10–15 minutes, no more. Sometimes a biopsy is performed when abnormal or highly suspicious areas are found. Next, the resulting material is prepared for further, more detailed study in a special laboratory. The results will be announced a little later.

After the nature of the biopsy sample has been established, the obtained data will be available to the patient and the attending physician: the direction of further treatment depends on the results of the study.

When treating the mucous membrane with iodine or acetic acid, the patient may feel a burning sensation - this is a normal reaction of the body to these substances. At this moment, it is recommended to remain calm. The essence of the procedure is briefly outlined in the video at the bottom of the page.

Indications and contraindications

As a rule, a diagnostic examination is particularly indicated in the presence of:

• genital warts (viral warts) on the surface of the mucous membrane of the cervix;
• any complaints of rashes, itching and pain in the vaginal area;
• severe pain in the lower abdomen combined with suspicious discharge during intimacy;
• nagging pain not related to the menstrual cycle;
• indeterminate result of previously taken cytology.

Colposcopy is also prescribed to confirm the presence of a malignant tumor in the cervix, vulva or vagina. Experts recommend colposcopic examination for all women who have overcome the 35-year mark.

As a preventive measure, colposcopy should be performed at least once a year.

In a small list of contraindications, it is worth highlighting the following points:

• allergic reaction to acetic acid or iodine (if extended calposcopy is to be performed);
• the first eight weeks after the birth of the child;
• recent surgical treatment of the cervix;
• the first 3–4 weeks after artificial termination of pregnancy (abortion);
• progressive inflammatory process;
• menstruation period;
• atrophy of the ectocervix.

On what day is it better to schedule a colposcopy? The first few days before the menstrual cycle and the week after its end are considered more favorable time periods.
In addition, you should not undergo the study if you have any type of vaginal bleeding.

Features of preparation

In most cases, the attending physician does not recommend preparation, since it does not involve much effort. But, nevertheless, it is worth taking into account several important rules.

At least one day before the study, you must abstain from sexual intercourse and insertion of tampons. For 3-5 days you need to forget about using special sprays, vaginal suppositories, lubricants and douches.

You should wash with regular warm water without using the usual store-bought products. If the patient has an increased pain threshold, the doctor prescribes her an anesthetic (Paracetamol or Ibuprofen), which should be taken immediately before the study.

Is it possible to perform colposcopy on pregnant women and virgins?

Do expectant mothers undergo colposcopy? Since modern young women are often exposed to cervical erosion, they are often recommended for diagnosis during pregnancy. In addition, in order to avoid some complications, the expectant mother will have to undergo a smear test before visiting the gynecologist's office.

Colposcopy is performed on most virgins. In such situations, the doctor uses small mirrors that will not damage the hymen. However, if a girl’s hymen has a solid shape, then the gynecologist will not conduct the study.

Some complications

Almost every medical procedure is accompanied by some adverse consequences, colposcopy is no exception. It is extremely rare that a patient after the procedure may experience pathologies such as:

• discharge of abnormal color;
• heavy bleeding;
• increased body temperature (38-39 °C);
• pain in the lower abdomen.

If such symptoms are observed for more than 2 days, you should urgently visit your doctor!

In case of complications that do not go away on the 2nd day after the study, you should under no circumstances ignore them; you need to see a specialist as quickly as possible, who will clarify the situation

Diagnosis of the cervical canal is necessary to identify precancerous conditions, malignant tumors, and other pathologies. Colposcopy is one of the most gentle procedures, during which it is possible to examine the vagina, vulva and cervix, and take tissue for cytological analysis.

Before the procedure, tests and ultrasound are prescribed, which suggest the presence of pathology. Based on the results of colposcopy, an accurate diagnosis can be made, since during the manipulation they not only take smears and endometrial tissue, but also visualize the condition of the mucous membrane by magnifying the image displayed on the monitor up to 40 times.

Decoding the results of the study allows you to prescribe competent treatment. The procedure causes virtually no complications, so it is performed even during pregnancy.

Most often used, as well as when a precancer or tumor is suspected. During manipulation, the integrity of the epithelium is examined; in the case of atypical foci, a smear and (endometrial scraping) are taken simultaneously.

Using this study, the effectiveness of therapy for various neoplastic processes is monitored. If there is a deviation from the norm, it is possible to re-sample tissue for cytology.

Simple

A simple colposcopy of the vagina is performed without the use of special staining substances to identify pathological foci of the endometrium. The study makes it possible to analyze the structure of mucus:

• presence of pus;
• smell;
• blood inclusions.

Based on the results of colposcopy, it is possible to accurately determine the size and shape of the cervix, ectocervix, the presence of growths, scars, vascular patterns, and clearly visualize the boundaries of the zones of transformation of the squamous epithelium into columnar epithelium.

In addition, a simple study determines the areas of the cervical epithelium affected by erosion, open glands, the localization and structure of polyps and other neoplasms.

During such an examination, a smear is taken only when indicated, since this increases the risk of bleeding and infection.

For simple colposcopy, low magnification is often used. Foci of damage, leukoplakia, endometrial structure, size and boundaries of neoplasms are assessed. Using a special green filter, the network of blood vessels is examined, which makes it possible to detect the presence of invasive cancer.

The procedure is painless, the risk of complications is minimized. If erosion is present, bleeding may occur after colposcopy. The norm is a scanty brownish secretion, ending within 1–2 days after manipulation.

Extended colposcopy

Colposcopy using staining agents provides more diagnostic capabilities. It requires careful preparation and special optics are used.

The main indication for colposcopy using Lugol's solution, acetic acid, adrenaline or trichlortetrazole is a suspicion of malignant processes. The following studies are carried out:

• adrenaline is used to diagnose changes in blood vessels;
• clear boundaries of the pathologically altered endometrium are determined by staining with Lugol's solution (iodine);
• 3% acetic acid is used to differentiate malignant tumors and visualize the location of the pathological focus;
• trichlortetrazole is used to determine the malignant degeneration of cells, indicating the absence or presence of a special enzyme characteristic of cancerous tumors.

Most tests using acetic acid and Lugol's solution are used in combination. The vinegar solution is applied to the cervix with a cotton swab, the results are assessed after one minute. In the absence of atypically changed cells, the vessels narrow. If the vascular pattern is not clearly visible, a suspicion of malignant degeneration arises.

Then diagnostics is carried out using Lugol's solution. It covers the entire suspicious area of ​​the endometrium. Undegenerated cells turn brown. Light areas of the mucous membrane indicate pathological changes. The test visualizes the boundaries of the changed areas using staining. Accordingly, doctors are able to scrape tissue only from the affected area.

Chromocolposcopy is a type of advanced method. During the manipulation process, the tissues are dyed:

• methylene violet;
• hematoxylin;
• toluidine blue and other dyes.

Multilayered squamous epithelium changes shade after application of these substances, cylindrical epithelium does not stain. This allows you to visualize the outer lines of the affected area and clarify the course of the pathological process.

For example, hematoxylin stains malignant cells purple, and normal epithelium stains light lilac.

The accuracy of such a cytology study is more than 90%. It is mainly prescribed to women who are suspected of having cervical precancer or malignant tumors.

Does colposcopy detect erosion?

In gynecology, erosion can be detected by routine examination. A procedure with a colposcope is prescribed if, during a mirror examination, the doctor detects deviations from the norm.

No special preparation is required for the procedure; most often, colposcopy is used immediately after a bimanual examination. In this case, there is no pain in the uterus or vagina.

Conventional or digital colposcopy is used. During the manipulation, erosion is revealed as a red or white spot, the boundaries of the ulcer, the degree of damage to the endometrium, and the exact localization of the process are determined.

Diagnosis can be difficult due to candidiasis due to thrush and pregnancy. In the first case, the mucus becomes white, opaque, and during the gestational period it becomes more viscous and difficult to separate. In this case, use a solution of acetic acid to remove secretions.

A simultaneous biopsy is prescribed if cancer is suspected. In this case, a small amount of tissue is scraped off at the location of the erosion and sent for further examination.

Types of colposcopy for erosion

Colposcopy of the cervix allows you to make a description of the eroded area. It is also carried out to identify polyps, growths, precancerous changes, endometriosis, dysplasia, and HPV.

The stages of the anomalous course are determined:

1. The first is characterized by inflammation that occurs in response to the development of pathogenic microflora. Exudation appears - swelling and release of fluid into the vaginal lumen. The exudate may be bloody or serous. Alteration characterizes damage to cervical tissue by microorganisms. In the productive stage (proliferation), the cells grow, replacing the mucosal defect.
2. The second is that a wound surface is formed, and long-term non-healing lesions of the mucous surface of the cervix are observed.
3. Third, the area of ​​the wound surface increases and develops. Possible improper healing of erosion, replacement of stratified epithelium with cylindrical epithelium.

In the presence of these symptoms and lack of treatment, dysplastic processes may develop, which are harbingers of malignant cell degeneration.

True

This diagnostic method is used to detect not only erosion, but also inflammation of the fallopian tubes, endometritis and endometriosis, and other pathologies.

Colposcopy of the uterine canal visualizes a wound that is not able to heal on its own within 2–7 days. This condition develops from a bacterial infection, an inflammatory process that is characterized by vaginal discharge.

Vaginoscopy of the vagina gives the following clinical picture when examining the cervix: tissue swelling, rejection of dead parts of the epithelium, deposits of fibrin threads.

In case of severe inflammation, an additional analysis is taken - a smear. Based on the results, the type of pathogen and its sensitivity to antibiotics are determined.

Congenital

It occurs in girls during the period of intrauterine development. The cervix is ​​modified, the columnar epithelium is located outside. More often, as puberty progresses, it shifts inward, but in the absence of a reverse process, ectopia is diagnosed.

Colposcopy of the cervix determines transformation zones (areas where squamous epithelium turns into glandular epithelium):

• transformation zone type 1 - colposcopy allows you to distinguish the entire lesion;
• 2nd and 3rd – the affected area is not completely visualized.

When examining the cervical canal and vagina with a colposcope, congenital erosion is detected (as partial or complete blockage of the cervical canal). This pathology is not life-threatening and often does not require surgical interventions.

After the procedure, a burning sensation in the vagina and scanty bleeding may be observed as a result of injury to the mucous membranes. The duration of such discharge does not exceed 1–2 days. Additionally, colpitis, endometritis and other concomitant pathologies can be diagnosed.

Pseudo-erosion

With pseudo-erosion, colposcopy shows:

• the area of ​​ectopia is defined as a spot with unclear boundaries of a bright red hue;
• the surrounding mucous membrane is pale;
• there are no ulcers or wounds;
• the so-called velvety surface is visualized - areas with red oblong or round papillae;
• the transformation zone (precancer) is characterized by the presence of metaplastic and immature multilayered squamous epithelium.

In the presence of pathologies (candidiasis, vaginitis), abundant whitish mucus and periodic brown discharge may additionally be present.

In this case, a simple colposcopy is needed, which will determine pseudoectopia. If transformation zones are detected, a biopsy is prescribed with further cytology to exclude malignant tissue degeneration.

Indications for use

The main indications for colposcopy are:

• cervical erosion;
• chronic pain in the sacrum and lower abdomen;
• diagnosis of endometriosis, leukoplakia, erythroplakia, precancerous processes;
• hormonal disorders;
• discharge from the uterus during the recovery period after surgical treatment;
• polyps, condylomas, endocervicitis.

If a woman is bothered by itching, stomach pain, or acyclic menstrual bleeding, a simple colposcopy is prescribed. In cases where suspicious modified lesions on the mucous membrane were discovered during the procedure, an advanced method with staining is used.

Possible contraindications

The colposcopic examination method is widely used during pregnancy and after childbirth; there are practically no contraindications for it. The study is not prescribed:

• after the use of cryodestruction or surgical treatment of the cervix;
• in the first month after surgical abortion;
• within 2 months after birth;
• if you are allergic to coloring components.

Temporary limitations are atrophy of the ectocervix, acute inflammatory process, bleeding from the uterus or cervical canal. Colposcopy is not performed during menstruation.

Tumors, including malignant ones, are a direct indication for such a study.

Necessary research

During preparation for the examination, the doctor conducts a routine examination:

• studies the condition of the mucous membrane;
• detects polyps, cysts and other neoplasms.

An abdominal or transvaginal ultrasound is also prescribed.

To clarify the nature of the pathology, a blood or urine test may be needed. If an atypical process is suspected, not the usual, but an extended technique with a biopsy is prescribed. Additional diagnostics can be carried out after deciphering the colposcopy.

What diseases can be detected

A number of diseases are diagnosed:

1. Oncology is visualized as glassy areas with bumpy projections and clearly defined vessels. When staining, there is no reaction of the mucous membranes - their color remains unchanged. In this case, the diagnosis of cancer can be made even without a subsequent biopsy.
2. White spots characterize leukoplakia - areas of keratinized epithelium.
3. Colposcopy after childbirth is prescribed in case of prolonged bleeding, if endometritis or endometriosis is suspected.
4. Erosion, infection and inflammation - the mucous membrane has a bright red color, elevations or depressions, and the tissue is swollen.

Colposcopy is also prescribed to examine papillomas (warty growths on the mucous membrane). In 1% of cases, such growths can degenerate into a malignant tumor.

Preparing for colposcopy

The following measures are required before the procedure:

• sexual intercourse and douching are excluded for 1–2 days before manipulation;
• Tampons and vaginal suppositories are not used.

Duration: 1–2 days before the start of menstruation or 2–3 days after.

Additionally, an examination is carried out and tests are prescribed. In the middle of the cycle, colposcopy is not performed; in case of emergency examination, acetic acid is used to remove mucus. This may cause an unpleasant burning sensation.

Sometimes testing for an allergic reaction is required because Lugol's aqueous solution and other coloring agents are used.

Execution technique

Colposcopy is carried out in several stages:

1. The colposcope is inserted into the vagina after pre-treatment of the mucous membrane with a 3% solution of acetic acid. A burning sensation may be felt due to irritation of ulcers and wounds.
2. The doctor assesses the condition of the mucous membrane - only healthy vessels narrow, and in pathologically disturbed tissues they remain unchanged.
3. This is followed by treatment of the pharynx with iodine solution. Damaged tissues are not stained (iodine-negative zone).
4. The doctor studies the nature of the damage by changing the magnification, which allows one to accurately determine the boundaries of the pathological foci.
5. Then a biopsy and smear are taken.

The image is displayed on the monitor. A color study is carried out to determine the structure and nature of malignant neoplasms after tissue treatment with blue or green dye. With the luminescent method, after applying special dyes, cancer cells are painted pink-blue and are visible under ultraviolet radiation.

Duration is about 20 minutes, the manipulation is performed on a gynecological chair using mirrors.

Colposcopy after pregnancy

Colposcopic examination of the cervical mucosa after childbirth reveals:

• erosion;
• polyps and cysts;
• scarring process;
• the need for a biopsy if modified areas of the epithelium are detected.

Duration: 6 weeks after delivery.

Postpartum procedure

Since colposcopy of the cervix is ​​not performed during menstruation or postpartum bleeding, the optimal period is the 7th week after childbirth.

The need for such a study is due to suspicion of polyps, endometriosis, inflammatory diseases, fibroids, hyperplasia, and the development of malignant processes.

A cervical examination is performed if the following symptoms are present:

• pain in the lower abdomen;
• discharge is dark, acyclic;
• discomfort during sexual intercourse.

During the manipulation, the structure of the epithelium is studied and lesions in the cervical canal are identified. The procedure is mandatory for those women in labor who are at risk of developing malignant tumors.

What complications can there be?

Immediately after colposcopy, you should not have intimate intimacy, use douching, tampons, or vaginal suppositories. Complications are rare and usually include:

• bleeding;
• pathological discharge of red or yellowish color;
• nagging pain;
• failure of menstruation;
• burning sensation when using acetic acid.

After colposcopy, it may be necessary to conduct additional studies - histological, ultrasound.

If the tests are unsatisfactory (increased ESR and leukocytes in the blood), a tissue scraping for biopsy must be taken during colposcopy.

Features of therapy

Treatment of complications:

• to stabilize hormonal levels and normalize menstruation, OCs or releasing intrauterine systems are prescribed;
• antifungal suppositories in the vagina can stop the development of candidiasis;
• in the presence of an inflammatory process, antibiotics are used;
• To strengthen the immune system, vitamin complexes and immunostimulants are prescribed.

You cannot place suppositories immediately after the procedure. Suppositories are used only after bleeding has stopped.

To carry out prevention, it is necessary to carefully select a specialist who will perform the procedure according to all the rules. Only a qualified doctor will be able to perform colposcopy and simultaneous biopsy without damaging healthy cells and traumatizing the mucosa.

After the procedure, the composition of the vaginal microflora is often disrupted, so the patient is advised to refrain from sexual activity and douching. Irritation may persist for 3–5 days.

There is no need to change your lifestyle. A woman should use pads if discharge appears as a result of a cervical examination.

Immediately after the procedure, you should ensure rest and medical supervision for at least 1 hour.

A colposcopic diagnostic procedure is prescribed in gynecology mainly for suspected erosion, polyps, endometritis, and malignant neoplasms. This painless, non-invasive examination technique allows you to identify all areas with modified cells by applying a special dye.

Digestive pathologies are caused by stress, sleep disturbances, and poor nutrition. A referral for examination is given by a gastroenterologist or therapist who has noticed signs of health problems.

However, why wait until the doctor sends you for an examination? Often, gastrointestinal disease develops without alarming symptoms and reaches an advanced stage at the time of detection.

The disease should not be allowed to develop.

People go for a colonoscopy to prevent colon cancer. With regular screening, half of the cases can be prevented.

To avoid the appearance of cancer, doctors recommend undergoing a preventive examination every five years. For people over forty, screening is mandatory.

Sometimes patients confuse the concepts of colonoscopy and colposcopy. The latter is used to study processes in the vagina.

The first stage is anesthesia. Performed for patients who experience severe pain.

Anesthesia is performed locally; the anus is treated with Dicaine ointment or Xylocaine. Anesthesia is not used during the method.

Anesthesia is rarely used. Colonoscopy is painless.

Duration is up to 7–10 minutes. Before diagnosis, the patient takes a relaxing drug.

A similar procedure can detect various lesions of the cervix and vaginal part of the uterus in women. Hysteroscopy is performed using a special optical system called a colposcope.

A hysteroscope is a special binocular with interchangeable eyepieces of varying magnification. In addition, there is a built-in lighting device that allows you to illuminate the mucous membrane during the examination process.

What is colposcopy in gynecology? This is a modern and highly effective way to diagnose diseases of the female genital organs.

Such an optical system allows a gynecologist to conduct a visual examination of the condition of the mucous membrane and diagnose a wide range of diseases without serious invasive interventions.

The resulting image can be displayed on a computer screen and also be recorded in its memory for subsequent study or to analyze the effectiveness of treatment.

Typically, the research is carried out in several successive stages. The woman is placed in a comfortable position in the gynecological chair, and the doctor inserts a speculum into the vagina, having previously cleaned the walls of the mucous membrane to obtain a clear picture.

Afterwards, the specialist turns on the device and begins a detailed examination of the cervix, assessing its general condition.

In some cases, an extended colposcopy is performed - in addition to the standard stages of a simple examination, the mucous membrane is additionally treated with Lugol's solution and acetic acid, which allows the tissue to be stained - the healthy mucous membrane will become brown, and the affected tissue will become whitish.

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Next, the doctor can perform a biopsy, that is, plucking an area of ​​mucous membrane for further examination in the laboratory for pathologies. Tissue is collected using special forceps, which may cause some discomfort.

A small wound remains at the site of the fence, but it heals quickly. On average, the procedure takes from 10 to 30 minutes, depending on the volume of the examination performed.

Other types of gastrointestinal diagnostics

If you cannot get rid of fear, intravenous sedation or general anesthesia is possible. Before starting the process, make sure that you are not allergic to the selected anesthetic.

It is necessary to remove contact lenses and obtain removable dental structures. Sedatives put the patient into a kind of sleep, help to relax, relieve anxiety, and dull sensations.

After sedation, the patient quickly returns to normal; there are practically no memories of the examination process. This is the most common choice for pain management; sedatives do not cause complications.

It is very important that the patient knows the answer to the question, how is colposcopy done and why is it necessary to undergo it? This allows you to properly organize preparation for colposcopy, as well as reduce the level of stress during it.

Other types of gastrointestinal diagnostics

Main dishes:

• soups based on vegetable broth;
• meat, fish, low-fat varieties;
• boiled eggs;
• fruits vegetables;
• compotes;
• water without gas.

• fatty foods, fried;
• smoked meats;
• whole grain porridge;
• sweets, fresh pastries.

Painfulness of the procedure

Some women seek a colposcopic examination for preventive purposes annually, every time they visit a gynecologist, but this is not a mandatory prescribed norm. However, there are a number of situations in which such a diagnostic measure is mandatory:

• when examined in a gynecological chair by a specialist, visible changes in the mucous membrane of the vagina and cervix were noticed, in particular when erosion was suspected;
• the patient complains of a burning sensation in the vagina, discharge that does not correspond to the cycle, pain during sexual intercourse;
• a cytology smear showed the presence of atypical cells;
• The event is mandatory for women who are registered at the antenatal clinic for cervical diseases;
• the presence of inflammatory gynecological diseases;
• the need for tissue biopsy;
• control after treatment of gynecological diseases.

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Contraindications

There are practically no contraindications for the procedure. The study is contraindicated only in cases of severe concomitant pathology that requires serious hospital treatment.

For example, in case of acute intestinal obstruction, acute diverticulitis or peritonitis, colonoscopy is prohibited.

Hemorrhoids are not a contraindication to colonoscopy. On the contrary, this procedure can be used to stop bleeding and examine nodes.

It should be noted that most contraindications are relative and the question of the possibility of performing a diagnostic colonoscopy in each individual case is decided collectively

• state of shock;
• myocardial infarction;
• perforation;
• peritonitis;
• acute form of colitis;
• the disease is at the last stage of development.

Colonoscopy is a serious endoscopic examination of the colon to diagnose its pathologies or disorders in its functioning. A diagnostic procedure is performed using a special device - a colonoscope, which allows you to examine the large intestine along almost its entire length.

During a colonoscopy, it is possible to quickly perform some therapeutic procedures: removing a foreign body that has entered the colon, stopping bleeding, excision of a polyp, etc.

This informative diagnostic method of endoscopic examination is suitable for those patients who have any complaints about problems with the gastrointestinal tract, on the basis of which the doctor may suspect diseases of the colon.

There are also absolute indications for colonoscopy; if they are present, other research methods will be useless.

Colposcopic examination is performed only if women have appropriate indications for the procedure and there are no contraindications. Indications include the following situations:

• Suspicions of benign or malignant neoplasms in the vagina and cervix, as well as precancerous processes.
• Identification of ectocervix foci and their nature.
• The need for a biopsy for subsequent morphological analysis and selection of treatment.
• The need to choose treatment tactics and additional diagnostic procedures.

In all these cases, colposcopy provides important information for the gynecologist and can be recommended for widespread use. However, it is always necessary to remember about contraindications that limit the use of this diagnostic method.

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In what cases should this examination method be abandoned?

• Recent history of childbirth (less than 4-10 weeks ago).
• If a woman has undergone destructive or surgical treatment for cervical erosion, etc.
• Based on previous studies, intolerance to a solution of iodine and acetic acid was revealed.

If a woman has indications for colposcopy, but there are also contraindications, then the method should be abandoned, choosing other methods of examination.