-  Miscroscopic (colposcope) examination of the cervix to detect cervical dysplasia & screen for cervical cancer



-  Follow up test when Pap Smear results are abnormal

-  High grade abnormality

-  Several low grade abnormalities

-  Examination of post coital bleeding

-  Clinic procedure

-  Preferably performed when no menstrual bleeding

-  But can de done at any time



-  Allergy to iodine solutions

-  Post biopsy discomfort +/- 24 hrs

-  Slight blood discharge 5-6 days

-  Should avoid heavy physical activity, sex, swimming for 24-48 hrs

-  No tampons for 1 week

-  Heavy bleeding should present to Dr/hospital

-  No effect on fertility



-  Colposcope

-  Vaginal speculum

-  Cotton swabs

-  Acetic acid (vinegar)

-  Iodine



-  Patient in lithotomy position

-  Speculum inserted into vagina

-  Colposcope placed at entrance to vagina to examine cervix (magnification x 6-10)

-  Green light enhances bleeding

-  Cotton swab to remove excess cervical mucus

-  Acetic acid applied to cervix

-  Abnormal cells become white

-  +/- iodine solution applied to cervix

-  Normal cells become brown

-  +/- biopsy as indicated





-  Application of acetic acid to cervical dysplaisa causes uptake of water & white appearance

-  May indicate need for further treatment or repeat Pap Smears




-  If normal: annual Pap Smears until x2 normal then routine

-  LSIL seen or suspected +/- Bx but not treat (unless HSIL)

-  LSIL on histo: repeat Pap Smears annually until x2 normal then routine

-  HSIL seen or suspected: Bx then treat based on histology

-  LLETZ (Large Loop Excision of Transitional Zone), cone Biopsy, carbon dioxide laser, cold coagulation, radical diathermy, cryotherapy (not CIN 3)

-  Hysterectomy: co-existant gynae disease, early invasive disease..






Pic (cervix):

Pic (procedure):