COLPOSCOPY: WHAT, WHEN, HOW, AND WHY?

Dr. Claude Allouche, Gynecologist-Obstetrician
Ahuza Clinic, Raanana, Israel
058 726 02 64

WHAT?
Colposcopy is a gynecological examination that involves examining the cervix and vagina using a colposcope and performing a biopsy if necessary.
A colposcope is a type of binocular magnifier that enlarges the image, enabling better visualization of the cervix.
Most modern colposcopes are connected to a digital camera, allowing the image to be viewed on a screen and photographed. Colposcopie engl

WHEN?
When is a colposcopy performed?
It is most commonly requested after an abnormal Pap smear or a positive HPV test.
It may also be performed:

  • To monitor the results of a treatment,
  • Due to cervical lesions,
  • In the case of unexplained genital bleeding,
  • Or for heavy, unexplained vaginal discharge.

The purpose of a colposcopy is to guide the gynecologist in performing a biopsy at the most suspicious area.
This examination can be performed in a hospital, a private clinic, or a health center.

HOW?
How is a colposcopy performed?
During the gynecological exam, the patient lies on her back.
The doctor uses a speculum to separate the vaginal walls and applies two dyes.

These dyes react with normal and abnormal cells, changing their color.

  • Lugol’s solution stains normal mucosa dark brown.
  • Acetic acid whitens abnormal cells.

Using the colposcope, the gynecologist examines the cervix and vagina with magnification. The contrast created by the dyes highlights abnormal areas.
If necessary, the doctor uses small, sharp forceps to take a small tissue sample, called a biopsy.

The laboratory analysis of this cervical tissue sample determines the nature and severity of any lesions.
The procedure lasts about 10 minutes. While it may cause minor bleeding, it is not painful as the biopsy is superficial and does not require anesthesia.

Post-biopsy bleeding is usually minimal and, according to most rabbinical authorities, does not render a woman nidah since it originates from the cervix and not the endometrium.
Bring a sanitary pad as a precaution.

WHY?
When a Pap smear is abnormal or difficult to interpret, or to monitor treatment, colposcopy allows for a clearer visualization of potential lesions using magnification and dyes.

The gynecologist can immediately assess the appearance of the lesions.
Colposcopy also enables targeted biopsies, providing a definitive diagnosis from the pathology lab within a few weeks.

The subsequent course of action will depend directly on these results.
A biopsy may reveal cervical cancer, which will require further tests to determine the extent of the disease.

However, a biopsy does not always indicate cancer. It may also detect benign lesions that can either resolve on their own or be treated long before progressing to cancer. This will be discussed in a future publication.

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