Colposcopy

Introduction

Colposcopy is the method for the further diagnostic approach of patients with cervical pathology, which was diagnosed using PAP smear or HPV-DNA testing. Colposcope is a stereoscopic microscope, which can offer magnification even of ×40 folds (Figure 1). Thus, cervical, vaginal and vulvar lesion can be identified with precision. By colposcopy the physician has the opportunity to receive punch biopsies for further identification of the inferior genital tract pathology (vulva, vagina, cervix).
Διοφθαλμικό στερεοσκοπικό κολποσκόπιο
Figure 1 Stereoscopic colposcope
Colposcopic technique

Acetic acid of 5%, iodine liquid (Lugol) are the solutions which are used to perform the colposcopy to identify cervical or other pathology of lower female genital tract. In addition, Monsel solution is a liquid which is required to stop spotting or even bleeding from the cervix or the vagina, after punch biopsies (Figure 2). Special equipment is necessary to perform punch biopsies or to recognize lesion of the endocervical canal. For patients with previous cervical and vaginal operation or patients during pregnancy who needs colposcopic evaluation, further experience is required (Figure 3).
Διαλύματα οξικού οξέως, Lugol και Monsel
Figure 2 Acetic acid, Lugol and Monsel solutions
Ενδοτραχηλικός διαστολέας, λαβίδα βιοψίας τραχήλου και ενδοτραχηλικό ξέστρο
Figure 3 Endocervical speculum, forceps for punch biopsy and sharp curette for endocervical canal
Classification

The most popular colposcopic classification of the cervical lesion is Reid classification. By this, cervical lesion can be distinguished in low and high grade (LGSIL & HGSIL). The former diagnosis must be confirmed by punch biopsies giving the final diagnosis of LGSIL, actually Cervical Intraepithelial Lesion 1 (CIN 1), or even HGSIL namely CIN 2 or CIN 3.

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Kalogiannidis doctor

IOANNIS Α. KALOGIANNIDIS MD, PhD

Associate Professor
Obstetrics Gynecology -
Gynecologic Oncology

SEE ALSO

gynecologist-testpap

Test PAP

PAP smear or test PAP is the collection of cell population from the cervix and the endocervical canal to identify cervical pathology, actually premalignant and malignant diseases.
papilloma-virus-hpv

HPV-DNA testing

Human Papilloma Virus (HPV) is related to cervical cancer in 99% of cases. Most often high risk subtypes concerning the malignant diseases of the female genital tract are the types 16 and 18.

Uterine Myomas

The uterine leiomyomas or myomas are the more frequent benign tumors of the female genital system.