Colposcopy is a procedure by which both preinvasive and invasive lesions of the cervix, vagina and vulva are diagnosed.
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Added: Jun 25, 2023
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Colposcopy Dr.Chaduvula Suresh Babu Professor Department of OBGYN GIMSR Visakhapatnam, AP, India
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
Introduction Sir Hans Hinselmann – Germany – 1927 Included in Integrated Cervical Cancer Screening Program
Instrument
Latest Generation
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
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
Colposcopic Findings Aceto -white area Schiller’s or Lugol’s negative area Surface Contour Margin Mosaicism Punctation Abnormal vessels Inter-capillary distance
Normal Cervix – Transformation Zone
Nabothian Cysts
Cervical Erosion
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
Abnormal Vascular pattern
Abnormal vessels
Abnormal vascular pattern
Mosaic Pattern
Aceto -white Lesion
Schiller’s negative area
Contraindications
Limitations
Treatment CIN II & III – Local Ablative procedures Need regular follow-up
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