Colposcopy with Cervical Biopsy

Overview

During this outpatient procedure, typically performed after an abnormal Pap smear, the physician collects a tissue sample from the cervix so that the cells can be examined under a microscope. In some cases, a biopsy may be performed to remove precancerous lesions or larger areas of abnormal tissue.

Preparation

In preparation for the procedure, the patient is positioned and a speculum is inserted into the vagina to expose the cervix. The physician places a microscopic viewing device called a colposcope at the entrance of the vagina. The colposcope provides an illuminated, magnified view of the cervix. The cervix may be numbed with an anesthetic injection, and forceps may be inserted into the vagina to grasp and support the cervix.

Preparing the Cervix

Before the biopsy is taken, the physician may choose to rinse the cervix with a vinegar or iodine solution, which causes abnormal cells to change color. This helps the physician visually identify the suspicious area.

Taking the Sample

A variety of methods may be used to take the biopsy. In cases where only a small amount of tissue is needed, the physician typically uses punch forceps. The tip of this instrument is equipped with a tiny circular cutting edge that can be opened and closed to grasp and retrieve tissue. The physician uses the forceps to remove a tiny button of tissue from the surface of the cervix. This process may be repeated to remove multiple samples from the cervix.

Other Techniques

If a more extensive biopsy is required, the physician may use a laser, scalpel or LEEP device to collect a larger cone of tissue. In some cases, a thin scraping device called a curette may be used to scrape a sample of tissue from the lining of the endocervical canal. This is called endocervical curettage.

End of Procedure

When the procedure is complete, the instruments are removed, and the patient is allowed to go home. The tissue is sent to the lab for microscopic analysis. The physician will provide aftercare instructions and follow up with lab results.