A colposcopy is a microscopic examination of the cervix conducted by a gynecologist in the doctor's office. A speculum is placed in the vagina and the cervix is cleaned off with a large Q tip of any debris or mucus. The cervix is then painted with saline (salt water) so the doctor can get a good look at the blood vessels on the cervix. Then the cervix is painted with acetic acid (household vinegar) which may cause some temporary vaginal burning.
We look at the cervix after the application of vinegar with the regular white light of the colposcope and with a green light filter as well. We pay close attention to any areas on the cervix that turn white after putting on the vinegar, and we also look at blood vessel patterns. Any suspicious or abnormal areas are biopsies. These biopsies are very small and do not harm the cervix at all. They are a little uncomfortable, but most patients do not think they are very painful.
We also take a brief scraping of the inside of the cervix (an endocervical curettage) to make sure that the abnormal pap test cells are not coming from inside the cervix where we cannot see. A thick, brown, pasty substance called monsells solution is applied to the biopsy sites to stop bleeding. Patients usually feel well after the procedure, require no pain meds, drive themselves home, and assume all of their normal activities and exercise.