Colposcopy

This presentation describes about the colposcopic procedure for detecting precancer cervical lesions in the female genital tract

1. Colposcopy Dr.Chaduvula Suresh Babu Professor Department of OBGYN GIMSR Visakhapatnam, AP, India

2. Definition It’s a procedure by which cervix is visualised to detect abnormal areas and also biopsy would be taken as and when required Magnification – 10-20 times Colpomicroscope – 100-300 times

3. Introduction Sir Hans Hinselmann – Germany – 1927 Included in Integrated Cervical Cancer Screening Program

4. Instrument

5. Latest Generation

6. Indications - Diagnostic Abnormal Pap Smear – CIN 1 with positive HPV Pap smear positive for malignant cells Pap smear suspicious of malignancy Abnormal Vaginal area Abnormal Vulval area To locate abnormal areas and to take a Biopsy Preoperative assessment of early cancer cervix

7. Indications - Therapeutic Cauterisation LASER therapy LEEP procedure LLEEP procedure Conization Cryotherapy Follow-up for CIN treated cases

8. Technique Proliferative phase No vaginal examination Cusco's speculum Lower magnification Saline application 3-5% Acetic acid – Aceto -white areas - VIA Green light filter vascular pattern – Vascular pattern Schiller’s Iodine – pale, negative areas - VILI

9. Colposcopic Findings Aceto -white area Schiller’s or Lugol’s negative area Surface Contour Margin Mosaicism Punctation Abnormal vessels Inter-capillary distance

10. Normal Cervix – Transformation Zone

11. Nabothian Cysts

12. Cervical Erosion

13. Colposcopy Findings Satisfactory – Squamo -columnar jt. i s seen Unsatisfactory – Squamo -columnar jt. Is not seen Aceto -white lesions Iodine negative lesions Abnormal vessels Mosaicism, punctations , raised areas

14. Abnormal Vascular pattern

15. Abnormal vessels

16. Abnormal vascular pattern

17. Mosaic Pattern

18. Aceto -white Lesion

19. Schiller’s negative area

20. Contraindications

21. Limitations

22. Treatment CIN II & III – Local Ablative procedures Need regular follow-up

23. HPV Vaccines 1. Bivalent Cervarix vaccine – for 16&18 2. Quadrivalent Gardasil – for 6,11,16 & 18 3. Nonavelent Gardasil 9 – for 6,11,16,18,31,33, 45,52 & 58

24. Thank You All