Sunday, August 3, 2014

Colposcopy: What You Need to Know

If you’ve been told you need a colposcopy, it’s likely due to an abnormal Pap test result. A Pap test is a screening tool that tells your provider whether there are any cell changes occurring on your cervix. A colposcopy is a more thorough diagnostic procedure that allows your provider to examine your cervix for any abnormal cells or blood vessels using a microscope known as a colposcope.

Don’t panic: An abnormal Pap test is very common–in fact, 10 percent of Pap tests show abnormal cells present. Most women who receive a colposcopy have a normal result, and follow up with a few more Pap tests to ensure their immune systems clear these cells on their own. Only a small percentage of these women will ever develop cervical cancer–in 2012, according to the CDC, there were only 12,000 cases of cervical cancer in the US, and most of these women did not have access to regular screening tests.

Why did my provider recommend a colposcopy?

There are several Pap test results that prompt a colposcopy:
  • Two Pap tests in a row that show a high-risk strain of HPV (human papillomavirus). A colposcopy will ensure that your Pap test didn’t miss any abnormal cells that HPV may cause.
  • Abnormal cervical cells (Pap test) with a high-risk strain of HPV. Your doctor will take a closer look at these cells to determine exactly where they are and how much they’ve changed since your last exam.
  • A Pap test that shows “high-grade” changes. Your provider will recommend a colposcopy if your Pap result shows cells that may have more considerable changes.
  • Abnormal cervical cells or HPV after a previous colposcopy. Your doctor will compare cells from a previous colposcopy and make sure they haven’t become more abnormal.

Is a colposcopy an urgent procedure?

No. However, you should get your colposcopy within three months of receiving your abnormal Pap results.

Why would I need to repeat my colposcopy if my first one was normal?

A Pap test is just a screening tool, while a colposcopy is a diagnostic procedure. So if, on a repeat Pap, your cells are still mildly abnormal or you still have high-risk HPV cells, you may need to repeat your colpsocopy to detect any changes to the cervical cells and confirm that you don’t have cancerous cells.

What is a colposcope?

A colposcope is basically a large microscope. It doesn’t enter your vagina or touch your body in any way. It simply magnifies your cervix so your provider can observe any changes.

What can I expect during a colposcopy procedure?

The procedure is very quick–about 10 to 15 minutes. Your provider will give you an opportunity to ask any questions, and before the colposcopy begins, he or she will conduct a quick urine pregnancy test.

For the procedure, you’ll be in the same position as you would for a Pap test. Your provider will use a speculum to expose your cervix and observe your cervical cells through the colposcope. He or she might use fluids like saline, a vinegar solution, or iodine to make abnormal cells and blood vessels more visible. Your provider may decide to take a small freckle-sized  biopsy or scraping of the cells to send to a pathologist to analyze. Some people feel period-like cramps when the sample is taken.

Do I need to do anything to prepare for a colposcopy?

  • Come to your appointment with a full bladder so your provider can conduct a pregnancy test. If you’re pregnant, let your provider know beforehand.
  • Don’t insert anything into your vagina for at least 48 hours before the procedure, including tampons, douching, creams, or other products, and avoid vaginal intercourse. If you use NuvaRing, you can keep it in place until the procedure.
  • To prevent discomfort during the procedure, you can take 600 to 800 mg (3 to 4 over-the-counter tablets) of ibuprofen one hour before the procedure (take it with food, and avoid if you have a history of stomach sensitivity).

What’s the aftercare for a colposcopy? 

  • For five days after the procedure, avoid vaginal intercourse.
  • Don’t take a bath for 72 hours post-procedure. Showering is fine.
  • You may notice a gritty brown (sometimes bloody) discharge for several days if you had a biopsy. This is residue from medication used to assist healing. Try to avoid sexual activity or using tampons during this time.

Can I get a colposcopy if I’m on my period?

Because a colposcopy requires a clear view of your cervix, you’ll need to reschedule your procedure for a time when you’re not bleeding.

Are there any risks associated with the colposcopy?

The biggest risk associated with the procedure is infection, if your procedure included a biopsy. The risk is extremely low, but you should be aware of the following signs and symptoms:
  • Bleeding
  • Foul-smelling vaginal discharge
  • Fever and/or chills
  • Severe lower abdominal pain
Be sure to let your provider know if you have any history of bleeding conditions or are on medications that affect your bleeding prior to your appointment.

What kind of provider performs colposcopies?

Any medical provider with specialized training can perform a colposcopy. Your provider may be an MD, a DO, an OB/GYN, a nurse practitioner, a physician assistant, or a midwife.

How do I make a colposcopy appointment at One Medical?

After your provider emails you a recommendation for the colposcopy procedure:
  • San Francisco: We set aside specific appointments for colposcopies at our Clay Street office. Colposcopy appointments typically book about a month in advance. If you’d like to be seen earlier, ask to be placed on the waitlist. We don’t have online booking for this procedure, so please reply to the email we send you or call us at 415. 644.5265 and ask for our colposcopy administrative team.
  • All other districts: Feel free to set up your appointment directly with the specialist we recommended in your email or any other OB/GYN of your choosing. Once you have that appointment, email us with the date of your appointment and the name of the specialist. We’ll send along a referral and your records so that your specialist knows your history.

Are colposcopies covered by insurance? What if I don’t have insurance?

Most insurances cover all or a large percentage of this procedure. For One Medical members who don’t have insurance, we offer convenient pricing options.

How long do I need to wait for my colposcopy results?

Generally, results take a maximum of a month. Your provider will contact you directly with the results and any follow-up recommendations.

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