What is seen in a colposcopy. Indications for the study

I have a gynecologist friend who has been in charge of the department for many years. operative gynecology. I remember, once upon a time, she gave out the phrase: "I don't need a colposcopy, so I see cervical cancer." Of course, since then a lot of water has flowed under the bridge and my girlfriend's point of view has changed. You don't really need a colposcope to see cervical cancer. Cancer is perfectly visible to the eyes during normal examination in the mirrors. The main problem and the main pain is that with the help of cervical screening (cytology and HPV typing) + colposcopy, we can prevent the development of cervical cancer by seeing changes in the level of CIN - cancer prestages - and treat it.

Cervical cancer is a preventable disease. That is why every case is a tragedy, and a neglected one is a disaster. Cervical cancer - it's definitely someone who blundered: either the patient did not go, or they did not take cytological smears, or they took it poorly, or they looked badly, or the smear came in 2 months, it was stupidly pasted into the card without calling the patient for an appointment.

The colposcope in case of obvious invasive cervical cancer is not a helper, but rather a hindrance. Once upon a time, when I was still working as an oncogynecologist and at the same time taking patients in private clinic, looked closely at the obstetrician-gynecologist from the local LCD. I liked her by everyone - both the way she writes and the way she talks, and she did colposcopy, and she competently led pregnant women. I was already quite ready to call the clinic - good doctors are always needed. One day, they ask me to do a colposcopy to a patient, "that's right urgently!" I'm coming, what's the urgency? - I ask.

- You see, OV, I don't like the patient's neck. She had a colposcopy by Dr. N - she sees simple ectopia and nothing more. And somehow it seems to me that there is not an ectopia at all.

I open it, I look - a clear invasive cervical cancer (then I looked with my hands - stage 3B, parameters are infiltrated. This stage is considered neglected, the prognosis is pessimo). For educational purposes I do colposcopy. I describe that a crater-like defect with a rough raised keratinizing ridge is visualized, pronounced vascular atypia, tissues bleed profusely on contact, etc. I don’t remember the further fate of the patient, but I didn’t invite Dr. N to work. She invited the one who brought me by the hand to review the patient, because she doubted the correctness of the colposcopic conclusion.

There is nothing wrong with the fact that a doctor who sees cervical cancer for the first time in his life does not make a correct diagnosis. The main thing is that he holds the patient by the hand and does not let go until a more experienced specialist looks at her. Fortunately, at a regular appointment, this pathology does not happen so often. In the oncology dispensary, up to 5-10 new cases per day. The district oncogynecologist has at least one new case per week. A typical obstetrician-gynecologist may have 1-2 cases in a lifetime.

It is incredibly difficult to draw up a protocol for a colposcopic conclusion. Or incredibly easy. You can simply use the classification of Rio, 2011 and write "Suspicion of invasion."
You can list the signs - atypical vessels, "fragile" vessels; uneven surface; exophytic lesion; areas of necrosis, ulceration, a sign of tuberosity.

I usually write immediately according to the FIGO and TMN classification. Cervical cancer - visual localization: it is necessary to stage with the eyes, pointing N x(no data on lymph node involvement) and M x(no data on distant metastases)

Let's take an example invasive cancer cervix on colposcopy and an example of incorrect design of a colposcopic report. To the credit of the colposcopist, she nevertheless suspected a malignant lesion of the cervix, having written before that a mountain of nonsense. But it is really difficult to draw up a protocol correctly. Therefore, I hide the personal data of the doctor. Yes, I'm here just now on FB to the question "How can a patient distinguish a good doctor from a bad one?" answered that good doctor He will give you a large piece of paper beautifully printed on a computer with a diagnosis, recommendations, a seal and a signature. Well, here is a big beautiful piece of paper with a seal, a signature, recommendations and my malicious notes.

So, the patient is 34 years old, B-0. In the summer of 2016, she turned to a gynecologist with complaints of ugly discharge. They examined him, looked for infections, said that there was "erosion", and began treatment. The treatment was not completed. The next time I went to the doctor in December 2017 with complaints about contact bloody issues(during sexual intercourse). 01/09/18 liquid cytology: cytogram with pathology of squamous epithelium. H-SIL. CIN 3, HPV-16+/ Invasion cannot be ruled out.

How often should a colposcopy be done? the patient asks.
- It's like someone. Who doesn't even need to do it.
- But I just recently did it and sent again.
- Got papers? Show.

I glanced at the colposcopy, "Oh, - I say, - you definitely need to do it, undress"
I start to introduce a mirror - it hurts a woman. I don't know how to explain it, but it's very characteristic symptom. It doesn't hurt as much as with vaginismus, it doesn't hurt as much as when trying to insert a larger-than-necessary speculum. It was at this point that I tensed up. I carefully open it - liquid sanious bloody discharge and a slight smell of decay. Not expressed, beating in the nose, when the decay is in full swing, but too small, barely noticeable.

Why did you come to the doctor? With bleeding after intercourse?
- Yes...

It is not possible to expose the neck in the mirrors immediately. Visualization is difficult - everything bleeds.

I try to put a condom on the mirror so that the side vaults do not interfere.

At the very least, we dry up. The picture is clear, but it is worth highlighting the colposcopic signs of invasive cancer.

We examine the vessels under the green filter

It is possible to find foci of rough ABE with rough puncture, although this is completely unimportant against the general background.

This general form in mirrors under low magnification. It can be seen that the cervix is represented by a tumor with an uneven tuberous contour. The tissues bleed profusely. This is no pronounced atrophy at 34 (see the previous speaker)! No adaptive vascular hypertrophy. There is no ectopic columnar epithelium here. And there is cervical cancer with a transition to back wall vagina

Cervical cancer T2a1 (Tumor that has spread beyond the uterus, without moving to the walls of the pelvis and affecting the lower third of the vagina, without involving the parametrium, tumor size is not more than 4 cm)
Curable stage. Extended hysterectomy (type III surgery) or radical radiation/chemoradiation therapy is still possible

The diagnostic procedure cervical colposcopy scares many women because of ignorance of what it is and why it is needed. First, you need to understand that the appointment of colposcopy does not mean at all that something is already wrong in the body - it is also used simply for examination. Secondly, its value as diagnostic method very high - the procedure allows you to identify serious illness and pathology in initial stages when treatment can bring very good results. At the same time, contrary to common fears and prejudices, the procedure is completely painless and does not involve deep intervention in the body. And now - about everything in order.

For starters, you should know the cervix. This is a diagnostic process, an instrumental examination of this organ, as well as the vulva, vagina. It is usually prescribed in order to confirm or refute the diagnosis, the suspicions of which arose from the gynecologist during a standard examination. And also colposcopic examination is carried out for preventive purposes. How often depends on age. So, it is recommended to pass it to all women leading sexual life, once a year. And twice a year.
Do a colposcopy of the cervix in a conventional gynecological chair, without anesthesia. Can be used at the request of the patient local anesthetic if a biopsy of the cervix is also expected. It is carried out in order to determine the nature of any tissue changes: malignant or benign. To do this, a tiny piece of tissue is plucked off for analysis with a special tool and studied in vitro - that is, in the laboratory. Even this procedure practically does not cause discomfort to the patient. And if we talk about whether it is painful to do a colposcopy in general, then we can definitely say that it is not.
There are two types of colposcopy: simple and extended. In the first case, the patient is placed in a chair, an ordinary gynecological speculum is inserted into her vagina. While the cavity is expanded, a colposcope is installed on the contrary - a device that allows you to examine the condition of the cervix both purely visually and on cellular level(look at the photo). After all, the device is a powerful microscope that can magnify the image up to 300 times.
There is an optical and video colposcope. In the first case, the doctor examines the patient's tissues directly, through the eyepieces of the microscope. In the second, the image is broadcast in real time to the monitor. This allows several doctors to study the image at once and assess the condition of the woman's organs. This is especially important when there are doubts about the diagnosis.
How a colposcopy of the cervix is performed in an expanded version is not much different from simple form. All the same, just for greater efficiency examination of the cervical tissue are treated with special reagents. Among them are 3% acetic acid, a solution of iodine or potassium, as well as Lugol. Processing with reagents makes it possible to notice changes that are not even visible to the naked eye. So, extended colposcopy using iodine is based on the fact that healthy tissues are stained, but diseased ones are not. Vinegar allows you to assess the condition of the vessels. The treatment of tissues with solutions is also done painlessly.
How long a colposcopy lasts depends on its type and the state of neglect of the disease. Colposcopy of the cervix is usually performed for 15 to 30 minutes. On average - 20. A simple examination of the cervix lasts faster, an extended one - a little longer. The video shows the procedure.

What makes it possible to detect the examination of the cervix with a colposcope

This examination can be carried out both for preventive purposes, and with certain suspicions of pathological processes that have arisen in the body of a woman. Here are the indications for colposcopy:

the presence of atypical cells, which revealed cytological examination smear taken from the cervix;
control and monitoring of the condition of a woman who has already had pathologies of the cervix;
suspicious areas of altered epithelium found during a standard examination;
suspicion of the presence of certain diseases of the cervix.

Thus, the main objective colposcopy - timely and early detection one pathology or another. The method allows to detect many diseases early, in the initial stages, due to which the treatment started on time brings positive results. Even cancer uterine cervix, noticed in a timely manner, can be eliminated without severe consequences for women's health.

This method is effective for identifying which diseases and pathologies: polyps, condylomas, cysts;

endometriosis;
cervicitis (inflammation of the cervix and cervical canal);
leukoplakia;
cervical erosion;
dysplasia (precancerous condition);
cervical cancer.

It is important that this method and biopsy analysis allow timely detection of all kinds of neoplasms and the beginning of their transformation into malignant ones.

So, for example, if the examination shows the presence of warts, this means that the patient is infected with the human papillomavirus (HPV). And the consequences of this disease can be severe - HPV is one of the main causes of cervical cancer.

Preparation for colposcopy of the cervix

Since cervical colposcopy is performed in a regular gynecological office, the procedure is quick, simple and painless, and preparation for it does not imply any special measures.

In general, you can lead a normal life.
Preparation for colposcopy of the cervix includes several points:

It is important to make sure that there is no pregnancy, if in doubt, notify the doctor in advance.
You should refrain from sexual activity 2-3 days before the procedure.
Do not use tampons, intimate sprays, tablets, suppositories or douche.
On the day of the event, wash with normal clean water without the use of detergents.
You can take any neutral pain medication before the colposcopy if you are afraid of possible discomfort.

The doctor should talk about the order of the procedure, its importance, possible unpleasant moments.
The doctor should notify the woman when it is better to do a colposcopy and on what day of the cycle. In principle, if the procedure is necessary, the sooner the better, then it can be done on any day, except for the menstruation itself. The fact is that bleeding will significantly distort the results and worsen the review. It is best to pass the examination in the first half of the cycle - three to five days after the end of menstruation. It can be later, but after ovulation in cervical canal a lot of mucus accumulates, which worsens the examination.
How much does a colposcopy cost depends on pricing policy clinic, the equipment used (video or conventional colposcope), the region in which it is located. The price varies from 1000 to 2500 rubles. In addition, do not forget that in a private clinic, before the procedure, you need to consult a doctor, which will also be paid. In a municipal clinic, usually the question of the cost of colposcopy of the cervix does not arise. The procedure prescribed by the doctor is free of charge.

Research results

The results of the study may show how normal condition cervical tissue, and abnormal. A healthy cervix is even, smooth, pale pink in color. The presence of pathologies is evidenced by:

non-standard vascular pattern - the capillaries are convoluted, arranged in a mosaic pattern;
punctuation - small red spots interspersed with light areas;
areas not stained with iodine - an unusual shape, structure.

During the study itself, the specialist pays special attention to modified, non-standard areas. What colposcopy shows should be interpreted by the doctor and only he. The interpretation of the results may not be clear ordinary person. It is possible to detect in non-standard areas both widespread erosion of the cervix, and precancerous, and even cancerous growth. Therefore, after the studies are carried out and the results are ready (and they will be ready from several days to two weeks, depending on the clinic), you must definitely come to re-admission to the doctor.
The doctor will give detailed description results, explain what to do next, and tell you what the cervical biopsy showed. If necessary, he will prescribe additional examinations and select the correct treatment.

Colposcopy and pregnancy

Many are interested in whether cervical colposcopy is possible during pregnancy. In general, bearing a child is a relative contraindication to the procedure. Relative, because if a colposcopy is absolutely necessary, the health, safety and future life of a woman depend on it, the procedure is carried out.
And colposcopy of pregnant women is also acceptable, if the gestation proceeds correctly, nothing threatens to interrupt it, the period is short, the fetus is attached correctly, the placenta is normal, and the benefits of the procedure exceed possible risks. Or if the pregnancy is planned to be terminated. If the pregnancy is desired, and possible complications for the future baby exceed the importance of the procedure, it should be abandoned.
In the case when a colposcopy is still necessary in this situation, it is carried out as far as possible without reagents. A biopsy is also undesirable during this period.

In any case, before carrying out a colposcopy, a woman should make sure that she is not or is pregnant. This and your own doubts should be told to the doctor in advance.

He will postpone the procedure until there is some clarity regarding the condition of the woman. And in case of emergency, he will carry it out with observance of all precautionary measures.

After the procedure

Since with such a diagnosis there is no special intervention in the woman's body, injuring her tissues, she can immediately go home after the procedure and lead a normal life. The only thing that can bother her is psychological discomfort.

Possible discharge after colposcopy - dark brown if the method was extended. The color of the discharge does not mean the presence of blood. This leaves the remains of iodine. Since it heavily stains linen, you can use a daily pad during this period.

There may also be discharge with a small admixture of blood - if the colposcopy was performed with the sampling of biopsy tissue. As a result, when it is injured, it is possible minor bleeding accompanied by slight discomfort and in the absence of pain.

The biopsy analysis performed during the examination imposes certain restrictions on the woman, in contrast to a simple procedure. So, for two weeks, she should refrain from sexual contact, severe physical work and sports, using tampons, vaginal suppositories and douching - until the damaged tissue heals.

Contraindications and complications

There are no absolute contraindications to this procedure. The following are relative:

Menstrual or any other uterine bleeding. Blood does not allow you to carefully examine the tissues of organs, assess the condition of the mucosa. The value of diagnostics in such a situation is practically zero. Therefore, it is possible to carry out a colposcopy only after the menstruation has passed.
Pregnancy. Any intervention in the female organs can be dangerous for the child. Read more above.
A recent birth or a female organs, operations. During this period, even colposcopy can injure tissues and harm the health of the patient. You should wait one and a half to two months, and in case of any complications - until they are completely gone.
Exacerbation of candidiasis (thrush). In this situation, inspection will be prevented copious discharge. You should wait for the candidiasis to pass, and only then carry out a colposcopy.
Virginity. Any manipulation this kind, including standard gynecological examination with a mirror, are held only for women who are sexually active.

Possible complications are also minimal and only occur if the procedure was performed by an unqualified specialist. As a rule, difficulties are associated with taking a biopsy for analysis. If this is done incorrectly or when using non-sterile instruments, an inflammatory process may begin. In which cases you should immediately consult a doctor:

heavy or long-lasting bleeding;
pain, heaviness in the lower abdomen;
temperature increase;
not bloody, but unusually heavy discharge for 5-7 days;
significant deterioration in general well-being.

The procedure and analysis, carried out according to all the rules, guarantee the safety for the patient and a quick recovery.

Anything that seems suspicious in its condition should be discussed with a doctor. In general, the success of the procedure largely depends on the specialist. He must tell all the information, starting with why a colposcopy is needed, how to prepare for it, and ending with what to do in case of certain violations. And most importantly, the doctor must take care of psychological state women and dispel all her fears - both before and after colposcopy.

Colposcopy is the modern standard gynecological procedure for examining a woman's vagina, cervix, and vulva. For its implementation, the gynecologist uses a colposcope, with special lighting and optical system. This procedure is usually recommended if the doctor finds pathological condition the cervix, vagina during a routine examination, or a cytological smear is abnormal.

However, there are cases when cancer can be suspected colposcopically in the absence of patient complaints, with a normal cytology and visual examination of the cervix. That is, colposcopic signs appear much earlier than cytological, and, moreover, visual ones. This is a very valuable method for detecting cancer at a very early stage and heal him. This procedure should be included in compulsory examination all women registered with antenatal clinic(myoma, endometriosis, etc.).

Ideally, colposcopy should be performed at least once a year for absolutely all women. Abroad, this procedure is performed on a woman annually, but a smear for cytology is taken every 5 years (colposcopy is cheaper).

During a colposcopy, the doctor may find any masses and take a biopsy for a thorough examination. laboratory diagnostics abnormal cells. Before the primary colposcopy, most women are worried because they do not have enough information about the essence of this procedure and the results of such a diagnosis.

What is the purpose of such a diagnosis?

Very often, it is with cervical erosion that colposcopy is important diagnostic procedure. It is used in order to timely diagnose and treat such diseases of the female genital organs as:

Genital warts, papillomas
Precancerous conditions of the vulva, vagina, cervical tissue
Cervicitis - inflammation of the cervix
Cancer of the vagina or vulva

Therefore, the indication for the procedure is any deviation from the norm during examination or smear analysis, and there are no contraindications to its implementation, except for the period of menstruation. Based on the results of the diagnosis, the doctor prescribes the appropriate treatment.

Preparation for colposcopy of the cervix

As a rule, it is recommended to carry out the procedure after the end of menstruation in the first 2-4 days. In the case when an examination is scheduled, and the woman begins menstruation, the procedure should be rescheduled. To prepare for a colposcopy of the cervix, you should:

2 days before colposcopy, it is worth giving up sexual intercourse
The same goes for using various candles, sprays, vaginal tablets unless the doctor has specifically recommended something to use.
Don't use tools intimate hygiene and wash the genitals with water only.
It is impossible to do self-douching a few days before colposcopy, especially since douching in itself is not in a safe way treatment (see).
No painkillers are required before the colposcopy - this is a completely painless examination , the same as before the examination by a gynecologist, mirrors are simply inserted, and the neck is examined under magnification, nothing touches it.

How is a colposcopy performed?

The colposcopic picture can be influenced and distorted not in better side factors such as mucus and palpation of the uterus and appendages, therefore:

The doctor removes the mucus from the neck and treats with vinegar and Lugol with a cotton swab, not a gauze swab.
Colposcopy is done before palpation of the uterus and appendages (the same applies to the exclusion of sexual intercourse the day before).

Colposcopy is extended and simple.

Simple colposcopy- when the examination is performed immediately after removal of the discharge from the surface of the cervix.

Extended colposcopy- is performed after treatment of the vaginal part of the cervix with a 3% solution of acetic acid, and after 2 minutes, examination begins with a colposcope. After such processing, any pathological changes become more clearly identified, since a short-term swelling of the mucous membrane occurs on the surface of the neck, and the blood supply to the tissues decreases. To determine the oncological location of cells, Lugol's solution is used (.) This method is called Schiller's test, with precancerous diseases, cervical cells are poor in glycogen and do not turn dark when iodine or Lugol is applied. Therefore, when oncological process whitish spots are traced against the background of a brownish fabric. Then the doctor can take a biopsy - a piece of tissue for histological examination.

A biopsy is a slightly painful procedure, as it is carried out with special forceps. A biopsy of the cervix is considered to be painless, sometimes there can only be a slight feeling of pressure and spasmodic pain. But with a biopsy of the vagina or vulva, it can be painful, for this a local anesthetic is used. In some cases, the doctor may apply and special remedy that reduces bleeding. During a biopsy, the gynecologist separates a small piece of cervical tissue, placing it in a test tube and sending it to the laboratory. After a colposcopy with a biopsy, a small 3-5 mm scratch remains, which heals quickly in a few days. Sometimes, in cases where next menstruation less than 14 days left, the biopsy may be scheduled for another day.

After 10-14 days, the results of the biopsy are usually ready, so after a colposcopy, you need to arrange with your doctor about the next visit, when the analysis is ready, in order to receive recommendations related to the results of the examination.

What can the results of a cervical colposcopy mean?

If the doctor detects altered areas during an extended colposcopy, then in some cases a biopsy is taken. In (ectopia), the affected area does not stain with Lugol, this only proves the presence of ectopia and a biopsy is not indicated.
But if:

pathologically altered vessels are visible (tortuous, intermittent, in the form of a comma, etc.)
punctuation - these are dotted inclusions in the area not stained by Lugol
mosaic is in the form of a quadrilateral in various shapes again on an unpainted area
whitish areas without changes -

then a biopsy is required.

Even with detected changes, only one at a time appearance the doctor will not be able to establish a diagnosis, everything will depend on laboratory data in 2 weeks. When histological analysis will detect a change in tissues, then it will be necessary to carry out additional surveys and therapy based on the result of the analysis.

What can not be done after colposcopy and biopsy?

If there was a colposcopy without a biopsy, then you can do whatever you want.

And if the colposcopy was with a biopsy, then after the procedure it is possible:

after a biopsy, a woman within 4-10 days may have drawing pains lower abdomen
appear sparse greenish or brown discharge(cm. ). Don't panic, these are the norm.

In order to avoid complications after colposcopy with a biopsy within 2 weeks, some rules should be observed:

Avoid sexual contact
You can not douche, use tampons, and use only pads
Can't drink medicines containing acetylsalicylic acid
Limit any heavy physical exercise, exercises
You can not visit the bath, sauna, exclude bathing, you should only take a shower

Colposcopy during pregnancy and biopsy

Pregnancy is not a contraindication for colposcopy. Since it is painless and safe method. Colposcopy has only one contraindication - the period of menstruation.

But it is better not to do a biopsy, because:

It can cause bleeding, miscarriage, premature birth, especially in situations where placenta previa is detected.
And not only because of this, but also because of the possible false-positive results of pathological changes in the cervix under the action of hormones during pregnancy.
In addition, it is still not possible to treat, if anything, until the woman gives birth (an exception may be cervical cancer, and then it is running).

Therefore, most often, doctors do not perform a biopsy of the cervix during pregnancy and postpone the procedure for the period after childbirth. Colposcopy without biopsy during pregnancy is safe and even if changes in the cervix are detected, as early as 6 weeks after the birth of the child, it will be possible to repeat the colposcopy and perform the necessary biopsy.

Colposcopy is considered a fairly simple and very common way to detect many diseases of the cervix. However, it is characterized a high degree subjectivity, because its effectiveness is largely determined by the literacy of the doctor. It is also extremely important to understand what day to do a colposcopy so that it is as informative as possible. We'll talk about this later in this article.

The optimal time for the study

Every woman should certainly take care of her health and undergo regular check-ups with a gynecologist. As part of such preventive examinations, doctors often prescribe colposcopy to patients.

Analysis

In order for the results of the analysis to be as accurate as possible and help to identify cervical disease in a timely manner, if present, it is better to carry out the procedure at a certain time in the woman's menstrual cycle.

After all, not every day of the cycle, the study of the epithelium of the cervix of the vulva with the help of a colposcope will give adequate results. Therefore, a woman should definitely ask about this fact at a consultation with a gynecologist.

Study

The optimal time for this method examination of the cervix of the vulva is the 1st half of the menstrual cycle of the fair sex. Qualified specialists appoint this analysis on the 3rd day after completion menses.

You should not carry out this procedure during menstruation, since the presence of blood and areas of torn mucosa of the vulva will close the doctor's view. Lack of visibility of the walls of the vagina and cervix can make colposcopy useless.

Another time

And if 2-3 days after the end of menstruation is missed, can a woman do a colposcopy at another time?

It can also be done after ovulation. At this time, the cervical canal is filled big amount mucus that interferes with the analysis. As a result, its results are distorted and cannot be considered accurate.

Also, the fair sex should not carry out the procedure in the second half of the menstrual cycle, since at this time its consequences will be somewhat more complex. The fact is that the mucous membrane of the organ after ovulation heals longer due to the slow pace of regenerative processes.

What are the restrictions

In principle, the study of the cervical mucosa with a colposcope does not have any restrictions. However, some points must still be taken into account by the patient who is going to undergo this species examinations.

Physiological changes in the body of the fair sex that accompany menstrual cycle, affect on the informativeness of the procedure. Therefore, if they are available, you should not agree to the implementation of this analysis. These changes are:

menstrual bleeding: at this time, any manipulations are generally not recommended for a woman, since the mucous membrane will heal very slowly. In addition, blood will interfere with any operation;
ovulation period: the presence of a large amount of mucus in the cervical canal distorts the results of colposcopy. The fact is that mucus is a consequence of changes hormonal background. Its viscosity at this time increases, so the information content of the analysis is reduced to zero.

Colposcopy of the cervix should not be performed when a woman receives local treatment inflammatory process. It is also worth postponing the analysis if very little time has passed since the moment when similar treatment ended. Do not take baths or douche the day before the study. Otherwise, its information content will be low.

How to prepare for analysis

When visiting a gynecologist, the fair sex should ask the specialist in as much detail as possible about optimal day for research this kind. It is necessary to determine the day of the onset of menstruation and count the 7th day of the cycle. If a woman is characterized by a too large or, conversely, too small cycle, the doctor must take this fact into account and determine the best day for analysis.

Colposcopy is a study of the vaginal part of the cervix, a detailed examination of it using a binocular microscope - a colposcope. For getting maximum number qualitative information during the procedure is used additional tests: treatment of the cervix with Lugol's solution and 5% acetic acid solution, the use of various optical filters. This allows the doctor to identify areas of tissue that are most suspicious of dysplasia.

Indications for colposcopy of the uterus

This study is used to diagnose many diseases, including a colposcopy is needed to identify:

genital warts;
precancerous changes in the tissue of the vulva, vagina, cervix;
cancer of the vulva, vagina, cervix.

It is necessary to do a colposcopy of the uterus in order to identify lesions of the epithelium of the ectocervix (the surface of the lower part of the cervix), determine their nature and localization, diagnose benign changes in the vulva, vagina and cervix, confirm or refute the appropriateness of a biopsy of the cervix, determine the site and method taking material for histological examination, to choose a method of treatment of the identified pathology.

Colposcopy during pregnancy is done to carefully examine the cervix to exclude invasive disease and the possibility of developing cervical cancer, to examine for the presence of neoplasms. The fact is that most women are not examined before planning pregnancy. If they already had a pathology of the cervix, against the background of suppression immune system(which is the norm during pregnancy), it can progress and adversely affect the health of the mother and the course of pregnancy. That is why during pregnancy colposcopy - mandatory research carried out, as a rule, without the use of diagnostic samples, and which is not capable of harming the fetus.

Contraindications

The procedure is absolutely safe, colposcopy is also prescribed during pregnancy, since there are no significant contraindications to it, they do not this procedure only in the first 6-8 weeks after childbirth and after the treatment of diseases of the cervix by surgical or destructive methods.

A contraindication to extended colposcopy is intolerance to iodine and acetic acid.

Preparation for colposcopy

There is no need for special preparation for colposcopy of the uterus. The procedure is not carried out only during menstruation. Not a very suitable period and the middle of the cycle, since at this time there is a lot of mucus in the cervical canal.

The best time to do a colposcopy is on the eve of your period or a few days after it ends.

within 1 - 2 days to refrain from vaginal sex without a condom;
do not use tampons for a day or two;
do not douche.

Carrying out the procedure

The procedure is carried out in the same way as a regular examination by a doctor in a gynecological chair. A viewing mirror is installed in the vagina, exposing the cervix, which allows you to study the epithelium of the walls of the vagina and cervix under a perpendicularly directed beam of light from a colposcope located a few centimeters away. The whole procedure usually lasts 10-20 minutes.

Colposcopy of the uterus can be simple (survey) and extended.

Simple colposcopy means without treating the cervix with any substances, and consists in examining the mucosa. According to it, the doctor determines the size and shape of the cervix, the state of its surface, the relief and color of the mucosa, the features of the vascular pattern, the border of the cylindrical and squamous epithelium, the presence and nature of ruptures, and evaluates the nature of the discharge.

Extended colposcopy is an examination of the cervix after treating its surface with a 3% solution of acetic acid, due to which, due to short-term swelling of the surface layer of the mucous membrane and contraction blood vessels, pathological changes on the surface of the neck are clearly detected. The next stage of extended colposcopy is the treatment of tissues with Lugol's solution - for the diagnosis of precancerous diseases. The point is that under these conditions epithelial cells are poor in glycogen, so the solution does not stain, which gives the doctor the opportunity to identify them.

Based on the results of the examination under the colposcope, the gynecologist will decide whether to do a biopsy (i.e. take tissue samples for additional analysis).

After colposcopy

If no biopsy was performed during the procedure, activity after colposcopy is not limited. Within 1-3 days, light bleeding is rarely possible - this is normal phenomenon. In this case, you should refrain from sexual intercourse, douching, tampons and medicines for several days until the bleeding stops.