What is colposcopy and how is it done. Progress of the process and possible sensations

Like many other diseases of the genital organs, pathologies of the cervix often do not manifest themselves with any symptoms. However, some of them have serious consequences and can sometimes lead to cancer. Therefore, for a thorough examination and diagnosis, doctors prescribe colposcopy of the cervix.

Many women, not knowing the specifics of the study, ask questions such as why to perform colposcopy of the cervix, when is the best time to make a diagnosis, what does the doctor study during the procedure and how long does it take. However, you should not be afraid of the procedure itself, since most often it is not painful and the physical sensations are not much different from a regular examination.

Colposcopy is a diagnostic method gynecological pathologies using a microscope (colposcope). A colposcope is a device that allows you to examine the patient’s cervical canal under magnification. During a colposcopic examination, the doctor pays attention to:

dimensions internal organs;
condition of the mucosal surface;
number, location, color and shape of foci of infection.

Diagnostics makes it possible to identify the smallest deviations of the vaginal epithelium from the norm. So, during the colposcopy process, the doctor pays attention to:

mucous color;
uneven surface of the vagina;
condition and location of blood vessels;
the presence, number, size and condition of the affected areas of the vaginal cervix;
presence and condition of glands.

The colposcopic examination of the cervix itself lasts up to 30 minutes. It is recommended to undergo diagnostics on days 3–5 of the cycle, since then the uterus begins to actively secrete mucus, which complicates the procedure.

Colposcopy is not performed during menstruation, as well as in the first 4-8 weeks after childbirth, to avoid damage to unhealed vaginal tissue. If there are inflammations and ulcers in the vagina, the procedure is also contraindicated.

There are no contraindications to colposcopy of the vaginal part of the cervix during pregnancy, but you should be especially careful when choosing a specialist. During pregnancy, the cervical canal expectant mother covered big amount mucus to protect the baby from infections. Since mucus makes it impossible to examine tissues, the doctor must be very careful when removing this protective layer with a cotton swab and during the procedure so as not to harm the expectant mother and the fetus.

If, during a standard preventive gynecological examination, the doctor notices damaged areas on the surface of the vaginal walls, he prescribes colposcopy, indications for which may include:

itching and pain in the genitourinary system;
atypical discharge (sometimes mixed with blood);
painful sensations during and after sexual relations;
constant pain and heaviness in the lower abdomen;
the presence of atypical cells in the smear.

However, if you notice one or more of these symptoms, you should not immediately run to a colposcopy specialist. The first step is to see your attending gynecologist, who will determine the possible causes of discomfort and prescribe treatment or additional examinations.

Preparing for diagnosis

Before undergoing colposcopy, the patient must follow some hygiene rules in order to maintain the natural balance of the vaginal microflora, so the doctor must warn her about the examination in advance.

So, in order to prepare for the procedure, a week before diagnosis, a woman should stop using intravaginal medications. For two days before the examination, it is necessary to abstain from sexual intercourse, and on the eve of the diagnosis, douching, the use of tampons and baths are not recommended, as this leads to a disruption of the composition of the natural flora of the vagina.

Also, before conducting the examination, the doctor must make sure that the patient is not allergic to the substances used during the examination. Most commonly used aqueous solutions iodine and acetic acid.

As a result of the use of solutions, a slight tingling or burning sensation may be felt, but usually this does not cause much discomfort or pain, since ordinary gynecological speculums are used in the diagnosis, and the colposcope is located outside. However, if the patient is particularly sensitive, it is recommended to take a painkiller tablet before the examination.

Carrying out the procedure

When diagnosing, the doctor examines the condition of the mucous membranes, notes the location, number and size of the affected areas, and preliminarily assesses the nature of the disease. If necessary, the doctor can take an oncocytology test for a detailed study to rule out suspicion of cancer.

Depending on what pathologies need to be identified, the doctor may use different methods inspection. Thus, there are three types of colposcopy:

simple (survey): the doctor examines the vaginal area of the cervix under magnification, without using chemical reagents;
extended: the doctor conducts some tests, checking the reaction of the mucous membrane with acetic acid or iodine solution, as well as using color filters, which makes it possible to identify pathologies at the initial stage of development that are indistinguishable during a general diagnosis;
colpomicroscopy: the doctor examines under multiple magnification (over 300 times), which allows you to evaluate the features internal structure cells.

Patients are usually prescribed an extended colposcopy. This diagnosis consists of 5 stages:

Throughout the examination, the doctor examines the organs on the computer monitor, indicating and commenting on his observations to the patient.

IN healthy condition the surface of the cervical tissues is smooth and even, predominantly Pink colour, and the vessels evenly cover the surface of the vagina. The results of the examination may indicate the presence of the following pathologies in the patient:

The results of cervical colposcopy with interpretation are given to the patient immediately after the procedure. So, upon completion of the diagnosis, the patient can receive examination data in the form of:

text with a verbal description of deviations;
a schematic map indicating the locations of the affected areas and their sizes;
photo or video colposcopy of the cervix.

Colposcopy of the cervix during pregnancy has no contraindications. On the contrary, a sharp change hormonal levels and physiological changes in a woman’s body during this period can lead to the development of pathologies, which can have a significant impact negative impact on the condition and health of the baby. Therefore, regular monitoring of the reproductive organs is often required. In case of severe damage to the uterine canals, the woman in labor is ordered to give birth by cesarean section. If changes in organs are not significant, then childbirth can occur naturally, and treatment is prescribed for the period after childbirth.

Even after examination by himself qualified specialist The possibility of various complications cannot be excluded. In addition to the carelessness of the doctor, discomfort after colposcopy may be associated with the physiological structure of the organs, overexertion, or non-compliance with the doctor’s recommendations.

Various complications as a result of colposcopic examination rarely occur. However, in cases where there are ulcers or other wounds on the vaginal mucosa, or as a result of a biopsy, the patient may experience brown, pinkish-red or bloody discharge within 24 hours after the examination. Also, the consequences of the procedure may be manifestations of painful sensations in the lower abdomen.

Despite the fact that the appearance of these signs is normal, if they last for more than 3 days, as well as in the case of elevated temperature, bleeding, or a change in character menstrual cycle You must immediately seek advice and help from a specialist.

Also, the possibility of infectious infection of the patient due to improper hygiene of the doctor, as well as due to the presence of open wounds on the surface of the cervical mucosa, cannot be ruled out.

To avoid the occurrence of various complications, a woman must observe certain rules for some time after the procedure. Doctors usually recommend avoiding elevated levels for several days. physical activity, douching and sexual intercourse, do not take baths or hot showers, and also do not take blood thinning medications for a week.

Attention, TODAY only!

Colposcopic examination is one of the most common diagnostic methods gynecological diseases. When faced with such a prescription for the first time, women do not know how colposcopy of the cervix is performed, what it is, whether this procedure is painful and whether it is necessary special training. Meanwhile, this examination is an important tool for identifying a number of pathologies dangerous to health.

What is colposcopy in gynecology

Colposcopic examination is an examination of the vaginal walls and the outer part of the cervix, which is carried out using special optical equipment - a colposcope. This device is equipped with a special optical and lighting system, which provides a 10-40 times increase in the visibility of internal organs, helping to conduct a thorough examination of them and identify even minor pathological changes that are invisible to the naked eye.

More modern equipment for conducting such a study is a video colposcope equipped with a digital camera. With its help, the image of the examined internal organs is displayed on the monitor. The results of video colposcopy are saved, and specialists can subsequently review them to analyze the effectiveness of treatment or assess progression pathological processes.

Indications

Since colposcopy is used to diagnose many gynecological diseases, it has a large number of indications. This examination must be prescribed if the results of a smear cytology analysis are unsatisfactory and if detected during an examination genital warts. In addition, the doctor may recommend a colpo test to the woman if there is the following symptoms:

prolonged pain in the lower abdomen;
vaginal discharge, itching;
vaginal bleeding not associated with menstruation;
bleeding and pain during intercourse.

Also, colposcopy can be prescribed in the absence of clear indications as an examination necessary to evaluate the results of treatment. This procedure has no strict contraindications. The only limitation for its implementation is increased sensitivity to acetic acid, iodine preparations or other reagents that are used for extended colposcopy.

How is it carried out?

When going for a colposcopy for the first time, women ask questions about how this procedure is done and whether it hurts. Colposcopy is performed after general gynecological examination, which is carried out using mirrors and allows only a superficial examination of the cervix. After this, the gynecologist proceeds directly to colposcopy, examining the cervix through the lens of the colposcope using different magnification scales.

If only a visual examination of the internal organs is carried out, colposcopy is considered simple, and when the doctor uses any additional tests to detect changes in the mucous membrane, this version of the procedure is called extended. If pathological areas are detected, a biopsy is performed - taking a fragment of the affected tissue for analysis.

What does it show

Colposcopy of the cervix helps to identify vascular changes in the mucosa, accurately diagnose diseases such as endometriosis, ectopia, erythroplakia, dysplasia and leukoplakia, and study in detail the nature and stage of development of erosion or other lesions. With the help of colposcopy, a gynecologist can identify in the early stages of development oncological pathologies– neoplasms of a malignant nature.

When is the best time to do it?

On what day of the cycle is colposcopy performed? The recommended time to carry out this procedure is the first half of the cycle, and it is best if it can be completed in the first 3-5 days after menstruation. During menstruation similar diagnostic tests not prescribed. Colposcopy during pregnancy is not prohibited and can be prescribed for different dates.

Preparing for colposcopy

Having learned about the features of cervical colposcopy, what it is and when the examination is done, all that remains is to figure out how to prepare for it. To this diagnostic procedure was as informative as possible, a few days before the visit to the gynecologist you will need to follow some rules regarding intimate hygiene, taking medications and sexual activity. If a doctor has prescribed a colposcopy for a woman, she needs to:

at least 2 days before the procedure, refrain from sexual intercourse;
during the week before the examination, do not douche or use by special means for intimate hygiene;
refrain from using contraceptive creams, vaginal suppositories or sprays unless prescribed by a doctor knowledgeable about the upcoming procedure.

What is extended cervical colposcopy

What are the features of extended colposcopy of the cervix, what is it, and how are its results interpreted? After a visual examination, the doctor uses a tampon to apply a small three percent solution of acetic acid to the cervix. Under his influence blood vessels in the mucous membrane they narrow, and this makes any pathological changes more clearly defined and noticeable.

In addition to acetic acid, iodine or special reagents that can glow under light can be used for additional examination. ultraviolet radiation. If there are affected areas on the cervix, then when iodine is applied they will not turn red. dark color, which will allow the doctor to accurately identify their location and scale. If other reagents are used, affected tissue may be exposed to light ultraviolet lamp paint in specific color.

Colposcopy results

After completing the procedure, the specialist draws up a written protocol - a form that contains information about the characteristics of the condition of the cervix and the presence or absence of signs indicating possible development pathologies. Interpretation of the results of colposcopy may contain descriptions of such anomalies as the formation of pathological vessels, the presence of whitened areas after treatment with acetic acid, the presence of areas not stained with iodine.

Colposcopy is a safe examination, does not cause side effects or complications such as pain or bleeding, and does not require recovery time. In rare cases, after the procedure, mild pain in the lower abdomen or slight discharge containing iodine may be observed, which disappears after 2-3 days.

Video: colposcopic examination

Special video materials will help you learn more about colposcopy and methods for interpreting its results. In them, experts provide detailed information about the specifics of conducting this examination, give advice on preparing for it, and talk about all the stages of its implementation. After watching the video, the woman will not have any unanswered questions.

Colposcopy is a diagnostic examination of the vagina and the part of the cervix adjacent to the vagina. The examination is carried out by a gynecologist using optical device- video colposcope.

Colposcope is a stereoscopic binocular device with a built-in source of directional light. Modern modifications of this device have a sensitive high-resolution digital video camera that transmits high-quality images to the monitor screen.

The device allows the doctor to examine in detail the mucous membrane of the cervix at multiple magnification, conduct a visual and test analysis of its structure for the presence of pathological cells. A biopsy performed under the control of a colposcope allows you to accurately select the required area for tissue sampling and reduce the likelihood false result almost to zero.

Reference!A biopsy is the removal of a tissue sample for histological analysis, in which the structure and properties of the tissue are examined, which makes it possible to identify its pathological changes, including malignant degeneration of the tissue.

Although colposcopy also examines vaginal pathologies, the method is more often used to diagnose cervical pathologies.

What does colposcopy show?

In the human body, cells with a damaged structure constantly appear - atypical, but the immune system recognizes them and destroys them in time. If the mechanism fails, the number of such cells accumulates, and the organ tissues gradually lose their normal structure. Then their malignant degeneration occurs - this is how cancer arises. Colposcopy shows the presence or absence of abnormal cells in the epithelium of the cervix, and allows one to suspect cancer and precancer. early stage. In addition to dysplasia and cancer, colposcopy can detect inflammatory processes cervix and vagina, as well as identify condylomas.

Colposcopy is prescribed in the following cases:

Positive result of the cytological smear.
Erosion and suspicion of inflammation of the cervix.
Inflammatory processes of the vagina.
The presence of highly oncogenic human papillomaviruses in a woman’s body.
Monitoring the treatment of diseases of the cervix and vagina.

The procedure can be prescribed routinely when the diagnosis is clarified - most often, when a “bad” cytology result is received. Also, during the examination, it can be performed urgently by a gynecologist if suspicious neoplasms or changes in the structure of the mucous membranes of the genital organs are detected.

Simple and advanced colposcopy

Colposcopy can be simple or advanced.

Simple- visual examination, which allows you to evaluate the color of the mucous membrane and its relief, the size of the organ, and the condition of the blood vessels. It is not performed as an independent diagnosis.

Extended colposcopy involves carrying out special tests - testing using reagents, which make it possible to reliably identify pathological zones. In this case, the surface of the cervix is treated with special substances that cause a response from living tissue. Healthy and atypical cells will react differently - this is what advanced research methods are based on.

Extended colposcopy there are these types:

sample with 3% acetic acid solution;
Schiller's test (mucous tissue is stained with Lugol);
dye test;
adrenaline test.

The most commonly used tests are the vinegar test and the Schiller test.

The point of performing the vinegar test is the unequal contraction of blood vessels around healthy and pathological tissue. The changed areas become whitish in color - they are called “acetowhite epithelium”.

When the mucous membrane of the cervix is treated with Lugol's solution, the normal epithelium becomes dark Brown color, the atypical one becomes gray or light brown. If the boundaries are clearly defined, this is iodine-negative epithelium.

When is the best time to do a colposcopy?

Our patients are interested in questions about the specifics of the examination. Most often, women ask doctors the following questions:

On what day of the cycle should I have a colposcopy? It is better to perform it immediately after the end of menstruation or at the end of the cycle, since ovulatory phase a large number of secreted mucus may interfere with the examination.
Is it possible to do a colposcopy during menstruation? It is forbidden. And also for any bleeding
Is it possible to have a colposcopy during pregnancy? Yes. Colposcopy is performed for pregnant women for the same reasons.
Is it painful to have a colposcopy? The examination is completely painless. However, if it is necessary to perform a biopsy of the vagina and vulva, the patient undergoes local anesthesia. A cervical biopsy does not require pain relief.
For many, it is also important to know how much a colposcopy costs. This procedure is not expensive, and the vast majority of patients can afford it.

As you can see, there is no point in being afraid and postponing colposcopy. The sooner cervical pathologies are identified, the greater the woman’s chance of complete cure.

Preparing for colposcopy

Before carrying out this medical procedure, it is advisable to follow these rules:

Refrain from sexual contacts 1-2 days before the procedure.
Do not use any vaginal products.
Do not douche.

Colposcopy does not require any other preparation.

Features of the regime after the study

If tissue was not collected for histology, the regimen after the procedure does not change. Most often there are no complications or discomfort.

If a biopsy was performed, it is not recommended for a week:

be sexually active;
lift weights;
experience increased physical activity;
visit saunas, baths, take hot baths.

After colposcopy, slight bleeding and nagging pain low intensity. You should consult a doctor if significant bleeding occurs, severe pain lower abdomen, increased body temperature. And also if bleeding began 3-4 days after the biopsy.

Contraindications to the procedure

This examination is considered safe, so there are few contraindications to it.

Temporary restrictions:

period after gynecological operations;
two months after birth;
menstruation.

An absolute contraindication is an allergy to vinegar or iodine (when performing an extended study).

How the research works

Colposcopy is performed in a gynecological chair. The colposcope is installed at a short distance from the entrance to the external genitalia. The doctor then inserts a speculum into the vagina and directs the microscope beam to the area being examined.

A visual examination is immediately performed - a simple colposcopy. The next stage is extensive research. The procedure lasts approximately 15-20 minutes. If it is necessary to collect tissue for histological examination, the process may be slightly longer.

The histology result usually comes in 10-14 days.

Evaluation of results

A diagnosis is not made after colposcopy - a conclusion is made, which the doctor makes based on the results of an extended colposcopy. They are described by the following terms: punctuation and mosaic. Puncture refers to a dotted pattern against a background of acetowhite epithelium. Accordingly, mosaic is a mosaic pattern.

Punctures and mosaics, in turn, are “gentle” and “rough”. The uniformity of the pattern is also assessed. The gynecologist considers the totality of these signs, compares the results of the cytological smear and analysis for the human papillomavirus, and ultimately decides on further actions.

If all the data indicate grade 2 and 3 dysplasia, the doctor performs a biopsy. An unambiguous decision on a biopsy is made if there are signs of cell malignancy. The doctor can leave the atypical zone of transformation of the 1st degree without a biopsy, at his discretion.

If signs indicate the presence of inflammatory processes, a biopsy is not required. The diagnosis of “dysplasia” or “cancer” can only be established based on the results of histological analysis of the tissue.

Content

Colposcopy in gynecology as a method for diagnosing forms of precancer and cervical cancer that cannot be detected by the eye began to be used since the 30s of the 19th century and has firmly strengthened its position. The analysis is used as a screening method, a method differential diagnosis infectious and oncological lesions of the cervix. Colposcopy helps the doctor distinguish normal epithelial cover from that damaged by microorganisms or a tumor process, and specifically select an area for biopsy and cytology. Thanks to the abilities this method diagnostics there has been a significant breakthrough in identifying and timely treatment cervical cancer.

Depending on the equipment of the clinic, both classical instruments and modern digital devices are used for analysis, which transmit the picture to a monitor and record video, which significantly expands the possibilities of decoding and the quality of diagnosis of cervical pathologies.

Diagnosis of cervical diseases is carried out comprehensively, including:

cytology of scraping from cervical canal, Pap test or liquid cytology;
Real-time PCR;
HPV Digene test;
biopsy;
tank. seeding of genital tract discharge.

Using Assays Individually cannot determine the true picture of cervical changes in a woman. Only a comprehensive deciphering of all methods of studying cervical pathologies allows an accurate diagnosis to be made.

Colposcopy of the cervix is an additional, but sometimes determining, analysis of the pathology. The technique is part of the annual routine preventive examination of women over 30 years of age.

In the process of deciphering, the doctor determines the condition of the tissues of the vaginal part of the cervical region, the cervical canal and each of them is formed various structures. Normally, the surface of the organ, visible in mirrors, is lined with multilayered squamous epithelial tissue, which has a pale pink color, and the internal canal of the cervix is formed by glandular structures - cylindrical epithelium. The glandular tissue is red in color, has a papillary structure, and produces protective mucus. The junction of two types of anatomical regions is called the transition zone (transformation zone) and is especially carefully examined during colposcopy. This transition most often undergoes tumor transformation. The colposcopy transcript must indicate the location of the transformation zone, which normally should be inside the canal. But in some situations - both pathological and normal - the transition can be localized on the surface of the cervical region.

In the process of deciphering the colposcopy picture, the specialist determines a number of pathological signs.

Open and closed glands in the interpretation are a sign of a disease, more often of inflammatory etiology; normally, the ducts are not identified.
Condylomas or flat papillomas on the surface are a consequence of HPV activity.
The vascular network should not be dilated if the transcript indicates atypical changes in the capillary bed (tortuous, corkscrew-shaped, without anastomoses), this may mean chronic inflammation, dysplasia or cancer.
Disorders of keratinization processes can also be identified during colposcopy analysis, these include keratosis, hyperkeratosis, acanthosis, leukoplakia, which is the result of chronic viral or bacterial infections, dysplasia or cancer.
Mosaic and punctuation in colposcopy deciphering means vascular pathology that occurs against the background of damage to the epithelial integumentary tissue by microorganisms. If a colposcopy analysis reveals a delicate mosaic and slight puncture of blood vessels, then this result is a consequence of inflammation. Rough mosaic and persistent punctation indicate dysplasia and cancer.
The boundaries of the cylindrical tissue should be clear and even if they are found on the surface. The transformation zone identified externally - ectopia - is subject to observation in the absence of signs of inflammation and other pathological phenomena during colposcopy. The transition zone is indicated schematically in the transcript.
In colposcopy, acetowhite epithelium means the presence of inflammation, and with a dense acetowhite layer, the presence of dysplasia.
A negative reaction to iodine in colposcopy indicates the presence of atypical epithelial tissue, which is recorded with ectopia, infectious lesions, dysplasia and cancer.

In addition to the above colposcopy results, the transcript may contain terms such as endometriosis, cervical canal polyps, Nabothian cysts. Endometrioid lesions are defined as bluish spots on the surface, especially pronounced at the end of the menstrual cycle. Polyps look like papillary glandular outgrowths, sometimes hanging on a stalk. Both types of formations are subject to removal and hormonal treatment.

The woman receives the result of the colposcopy interpretation immediately after the analysis. If necessary, a targeted biopsy is performed from the pathological area.

Methodology for performing analysis

Colposcopy analysis involves examining the surface of the cervical uterus under a special microscope - a colposcope. The device magnifies the image many times (5-40 times), the gynecologist examines the organ at low magnification, and then at high magnification. The analysis is divided into two types: simple and extended, which will be reflected in the transcript.

Simple technique implies an examination with magnification, and an expanded one - treatment of the cervix with reagents, which makes it possible to assess the degree and type of damage to the epithelium of the cervix.

The sequence of actions when analyzing colposcopy consists of several stages.

The cervix is exposed in speculums. Remove mucus from the surface with a cotton swab.
An examination is carried out at low magnification: 7-20 times; the transcript records visible changes, as well as the state of the transformation zone, pharynx, color of the epithelium, and the presence of changes visualized at low magnification.
An advanced analysis is performed: the cervix is treated with a vinegar solution for 30 seconds, which leads to a clear distinction between the stratified squamous epithelium and the cylindrical epithelium. The epithelium of the cervical canal turns white from vinegar. In this case, the presence of whitish areas on the surface of the cervix indicates ectopia, which is indicated in the transcript as acetowhite epithelium. This result indicates a positive reaction to vinegar. In the transcript of colposcopy, they schematically indicate which specific areas have a positive reaction.
A Schiller test is performed: the surface of the cervix is treated with an iodine solution. Those areas that have become brown are covered with squamous epithelium - positive test to iodine - this type of reaction is considered normal. A negative test means the presence of columnar epithelium on the surface, which does not stain. The transcript indicates a negative or positive test when processing the cervix. A negative result may indicate both pathology and individual characteristics location of the transformation zone.
After performing tests during extended colposcopy, the doctor, in decoding, indicates on a schematic drawing of the cervical uterus in which areas positive and negative results. Next, if necessary, a biopsy is taken from suspicious lesions for histological analysis.

Analysis transcript

Colposcopy allows not only to detect pathology, but also to differentiate various signs, inherent in acute or chronic inflammation, dysplasia or cancer. In the process of applying reagents and assessing the results, the doctor has the opportunity to suspect with a high probability a benign or malignant process before receiving a histology transcript.

Inflammation and ectopia

According to the 3rd International Classification, the extension of the cervical epithelium beyond the endocervix is indicated in the colposcopy transcript as “cylindrical epithelium,” but with a note on the size of this focus. Previously, the presence of glandular tissue instead of squamous epithelium was always considered ectopia, but currently such a site, in the absence of sexually transmitted infections and other pathological conditions, is a variant of the norm. In young women, during pregnancy and after childbirth, columnar epithelium is often observed on the surface of the cervix.

The wider the advancement of the epithelium of the cervical canal from the external os along the periphery of the cervix, the more concerned this condition causes doctors. In the vast majority of cases, the abnormal arrangement of the columnar epithelium is a sign of the disease.

The presence of glandular tissue in an atypical location in each individual case requires a more detailed diagnosis. In almost 60% of patients, when performing a colposcopy analysis, swelling and intense redness of the ectopic area are detected, which indicates in favor of infectious inflammation in acute or chronic form.

Depending on the severity and duration of inflammation, the type of microorganisms that caused the infectious process, the epithelium of the cervix responds with various reactions:

the degree of movement of the junction of two types of epithelium;
changes in the shape of the external pharynx (even in nulliparous women, the endocervix turns out and an eroded ectropion can form);
cervical hypertrophy;
formation of closed and open glands of the cervical canal;
loss of functions of the integumentary epithelium (disappearance of glycogen granules);
variability of vascular pattern;
disruption of keratinization processes of squamous stratified epithelium (acanthosis, hyperkeratosis, parakeratosis);
pathological mucus production.

These changes in the analysis are recorded using a test with vinegar and iodine, and are indicated in the transcript.

When performing a simple colposcopy, the columnar epithelium is described as a zone of hyperemia (redness), with the presence of folding, papillae, and translucent vessels. In an extended analysis, the transcript indicates a positive reaction to vinegar and a negative reaction to iodine - this means the presence of glandular tissue of the cervical canal on the surface of the cervix. Normal squamous epithelium is described negative reaction for vinegar and positive for iodine.

Chronic inflammation, initiated by bacteria and viruses, leads to a change in the nature of cell division, the formation of abnormal tissue areas, dysplasia, polyps, and cancer. Colposcopy allows you to detect all the changes occurring in the integumentary epithelium of the cervix, but the experience of the specialist, the quality of the analysis performed and interpretation of the results are also of great importance in interpreting and making the right decision.

In the presence of cervical diseases, cytological analysis reveals identified changes in the cells. During inflammation, the transcript indicates an increase in the size of the nuclei, increased staining (hyperchromatosis), dystrophic changes cytoplasm. Chronic inflammation is described by an increase in the number of leukocytes, changes in the cytoplasm (necrobiosis, severe dystrophy); in viral infections, the presence of koilocytes is noted. While during colposcopy the transcript describes:

ectopia (or columnar epithelium);
open and closed glands;
metaplasia;
negative reaction to iodine, both focal and extensive;
acetowhite epithelium (not always);
thin leukoplakia;
delicate mosaic or punctation;
strengthening of the vascular pattern.

In cases of severe acute inflammation, purulent discharge yellow or green. When treating an inflamed cervix with vinegar during analysis, short-term pallor and the appearance of tortuous vessels are noted.

The most striking and typical inflammatory changes during colposcopy are found in gonorrhea, minor manifestations in the analysis are characteristic of chlamydia.

Chlamydia

Chlamydia is characterized by the extension of the cylindrical epithelium by 3-5 mm beyond the border of the external pharynx, hypertrophied papillae (a type of “eggs”) resembling a polyp of the cervical canal on a wide base, bleeding, vasodilatation, an iodine-negative zone, delicate mosaic and punctation. With myco and ureaplasmosis, the same changes in decoding are noted, but experts note the appearance of the vessels as a “honeycomb” when treated with vinegar.

Candidiasis

With thrush, during a simple colposcopy of the cervix, swelling and hyperemia of the cervical canal and the surface of the cervical region are noted after removal of the cheesy plaque. When analyzing a vinegar sample, the presence of white inclusions is noted, which create a picture of defects in the stratified squamous epithelium. Testing with iodine is described by a spotted cervix, since fungal colonies do not stain.

Gardnerellosis

Bacterial vaginosis during colposcopy is characterized by dilated capillaries, large blisters around the external pharynx, no reaction to vinegar is detected, and analysis with iodine is ambiguous. In general, no epithelial pathology requiring biopsy is observed.

Trichomoniasis

Trichomonas cervicitis, which caused chronic colpitis, cervicitis, endometritis in last years due to increasing resistance to traditional treatment, it is a problem for many women. During colposcopy, the transcript indicates the presence of cervical edema, barrel-shaped shape, vasodilation, significant movement of the cylindrical epithelium (ectopia), punctation, mosaic, leukoplakia; on the periphery of the cervix, white dots in the form of “semolina” are found that are not stained with iodine. The analysis for iodine staining is generally ambiguous; the vinegar test is positive.

Dysplasia and cancer

Despite the improvement of methods for diagnosing cervical diseases and the accuracy of the tests performed, cancer still occupies a leading position among pathologies of the female reproductive system.

During a colposcopy It is impossible to determine with complete certainty dysplasia and cancer, since the signs of inflammation and oncology largely coincide. The final diagnosis is made after a targeted biopsy.

For dysplasia and the initial stages of cervical cancer, the following instructions in the transcript are typical:

dense acetowhite epithelium (resistant positive reaction for vinegar);
atypical vessels;
when analyzed with iodine, a negative reaction is noted;
violation of keratinization of the epithelium in the form of hyperkeratosis, acanthosis;
foci of leukoplakia with dysplasia;
rough punctuation and mosaic.

If an unsatisfactory interpretation of colposcopy is received, a targeted biopsy is performed, which can also be performed during colposcopic analysis. Histological analysis tissue allows for an accurate diagnosis.

On initial stages cancer, it is often quite difficult to identify the line between the third stage of dysplasia and microcarcinoma. Therefore, the presence of unsatisfactory results is considered a reason for extended conization of the cervix with the capture of healthy tissue. The deleted section is subsequently sent to histological examination, where the quality of the excised pathological areas is determined: if atypical cells are found at the edge of the removed cone, conization is repeated.

The clinical diagnosis of cervical disease should be made on the basis of several tests performed as part of a comprehensive diagnosis. After colposcopy, further examination of the patient becomes targeted. Adequate interpretation of colposcopic data makes it possible to detect cervical dysplasia and cancer at an early stage. The technique provides the most accurate biopsy, which allows you to fully diagnose the pathology.

Colposcopy is an instrumental research method during which a specific device is used - a colposcope. Using the technique, the cervix is examined using magnification and special lighting. Colposcopy is performed on a gynecological chair. The name of the method literally translates as “examine the vagina,” and it was first introduced into medical practice by H. Hans, who, using a special magnifying device, discovered it in a woman being examined. Modern colposcopes increase the minimum 3 and maximum 40 times. Some devices have special devices that allow you to more accurately examine the vascular bundles of the vagina and cervix. Also, modern devices are equipped with photography and video surveillance options, which allows you to record or photograph the results of the study for future evaluation. This option is especially important for assessing the dynamics of the disease and the success of the treatment.

The colposcopy procedure is included in the complex gynecological research for many diseases. The doctor decides individually whether the procedure should be used, but general indications for it are the following conditions:

Discharge of various types from the vagina (especially with an unpleasant odor and accompanied by itching);
Bleeding from the uterus or vagina outside the menstrual cycle;
Painful sensations associated with sexual intercourse or of a permanent nature;
Bloody discharge after sex;
Aching or nagging pain in the lower abdomen (constant or intermittent);
The presence of genital warts on the external genitalia (and any other manifestations of HPV);
Suspicion of an oncological process in the cervix.

Often, using this research method, an oncological process in the cervix is confirmed or excluded, and the presence and severity of erosive degeneration in this organ is also assessed.

Contraindications for the study

Despite the fact that colposcopy is a common examination that is used quite often, it has a number of contraindications. The main reasons why colposcopy cannot be performed:

Allergic reactions to iodine or acetic acid;
Two months after the completion of labor;
One month after the abortion;
Some time after surgical intervention on the cervix or after treatment with minimally invasive methods, for example, cryodestruction;
Bleeding from the genitals;
Inflammatory process in the acute stage;
Atrophic changes in the vagina.

Some of these contraindications are permanent, but most are temporary nature, therefore, diagnosis using colposcopy can only be postponed, but not canceled altogether.

How to prepare for colposcopy?

This procedure requires some preparation so that the doctor can evaluate reliable results research. Therefore, preparation for the colposcopy procedure begins with abstaining from sex a few days before visiting the doctor. You should also not use any products during intimate hygiene procedures, and douching before colposcopy is strictly prohibited. The best way to wash your genitals is warm water without application additional funds. In addition, before the procedure, a few days before it, it is recommended to avoid any medicines, especially, local application. The exception is those drugs whose use has been approved by a doctor. Girls are often interested in which day of the cycle to do a colposcopy in order to get the most correct results research. In most cases, the technique is carried out immediately after the end of menstruation, that is, a day or two after the last day.

It is not recommended to carry out the procedure during menstruation, so during the consultation the doctor should question and take into account the characteristics of the patient’s menstrual cycle.

Is it possible to have a colposcopy during pregnancy?

Pregnancy is neither an absolute nor a temporary contraindication for this procedure. However, the girl must inform the doctor about her situation. The main reason for prescribing colposcopy in pregnant women is the suspicion of oncological degeneration of the cervix. The procedure should only be performed by an experienced doctor, since during pregnancy the lumen of the vagina and cervix may become blocked by mucus. When confirming the oncological process, a biopsy can be taken, but this is not recommended without direct indications. The mucous membrane of the vagina and uterus is excessively supplied with blood during pregnancy, which is why a biopsy can lead to uterine and vaginal bleeding. Treatment of pathologies detected during colposcopy in pregnant women may be postponed indefinitely. However, in the presence of life-threatening pathologies for the mother, therapeutic measures can begin regardless of the timing of pregnancy and possible risk for the fetus.

How is colposcopy of the cervix performed?

The procedure is performed only by a gynecologist in a special room designed for procedures and equipped with a colposcope. Many people wonder: is it painful to have a colposcopy. It is worth noting that the procedure is completely painless, but some discomfort may be caused by taking biopsies from particularly suspicious places on the cervix. The examination apparatus is installed at a distance of 20–25 cm from the cervix. In this position, all visible areas of the cervix are examined, adjusting the magnification and inspection angle using special screws. The research is often carried out first of all. How is colposcopy done? various reasons, to assess certain properties of the cervix, there are several different types carrying out the methodology:

Survey colposcopy is the most commonly used technique, as it does not involve the use of additional means. With its help you can evaluate general state organ walls, pathological changes in the mucosa, disruption of the lumen of the cervical canal and other characteristics.
The use of filters allows a more accurate and detailed assessment of the condition of the cervical vasculature.
Extended colposcopy of the cervix is a technique that involves the use of some additional substances, for example, iodine or acetic acid. Using this type of procedure, it is possible to confirm the presence of oncological degeneration of mucosal cells.
Colposcopy using dyes also allows one to evaluate pathological changes in the mucous membrane, since those areas that have succumbed to neoplasia will not be stained.
Colposcopy with magnification up to 300 times allows you to evaluate even the composition and normality of the cells of the cervix.

The procedure takes on average just over a quarter of an hour. In this case, the woman undresses from the waist down and sits in a gynecological chair, where the doctor first conducts a visual assessment of the condition of the genital organs and vagina using mirrors, which remain inside during colposcopy. During the procedure, the vagina is periodically irrigated saline solution, which avoids drying out. During the study, if necessary, tissue is taken (biopsy) or scraped (curettage).

These additions to the procedure can give the woman discomfort, which pass quickly. After colposcopy, you should not douche, use tampons, or use local products for about two weeks. medications. You should also avoid any intimate hygiene products other than water. Sex is also prohibited for several weeks after colposcopy. The procedure may result in bloody or greenish discharge from the vagina, which is why you need to use panty liners for a couple of days. An important factor is the absence of odor in such secretions.

Interpretation of the results of cervical colposcopy

Exists unified classification the results obtained after colposcopy. It includes three large groups:

Normal mucosa;
Benign changes in the mucosa;
Abnormal epithelium (this group is also divided into simple abnormality and increased).

The doctor also separately evaluates the vessels, which may be unchanged, dilated, or pathologically tortuous. The group of simple abnormal epithelium includes precancerous conditions, when cell degeneration has already begun, but has not yet reached malignancy. All forms of cancerous degeneration of the cervix or if they are suspected have increased abnormality. Benign changes in the cervix include inflammatory processes, for example, colpitis, atrophic degeneration, cervical erosion, pseudo-erosion and the presence of polyps (and, depending on the cause of their appearance, the risk of malignancy can be either minimal or almost 100%).

Complications after the procedure

Colposcopy is absolutely considered safe procedure, which practically does not cause complications. Normal physiological reactions after it are carried out are:

Discharge with bloody or greenish impurities and no odor;
Discomfort and moderate pain in the lower abdomen (especially if curettage was performed).

These unpleasant sensations should disappear within a few days, but in rare cases, the mucous membrane becomes infected, causing additional symptoms:

Pain in the lower abdomen (increasing);
Increase in temperature to subfebrile, and sometimes to febrile levels;
The appearance of discharge that has an unpleasant odor;
Gain bloody discharge(up to the development of uterine bleeding).

Any of the listed symptoms that do not go away within 24 hours is a direct indication for an immediate visit to the doctor. In order not to miss the development of complications, a woman should carefully evaluate her condition for several days after the procedure.