Overview

Colposcopy is a diagnostic procedure used to examine the cervix, vagina, and vulva using a colposcope. It is essential for evaluating abnormal Pap smears and guiding biopsies.

Colposcopy is crucial for detecting precancerous and cancerous lesions of the cervix. It guides biopsy and management.

Learn more in our comprehensive RxDx OBG Course

Indications

✓
Abnormal Pap Smear

ASCUS, LSIL, HSIL

✓
Suspicious Cervical Lesions

Visible lesions

✓
HPV Infection

Screening for dysplasia

✓
Follow-up of Treatment

Monitoring

✓
Postcoital Bleeding

Evaluation of bleeding

Contraindications

Absolute Contraindications

✗ Patient refusal

Relative Contraindications

✗ Active vaginal infection
✗ Heavy menstrual bleeding

📋 Equipment Checklist

Check off items as you gather them:

Pre-procedure Preparation

Preparation includes patient consent, proper positioning, and equipment setup.

Step-by-Step Procedure

Step 1: Patient Preparation

Explain procedure, obtain consent, position patient.

⚠️ Common Mistakes to Avoid:

  • Inadequate consent
  • Poor positioning

💡 Pro Tip:

Position patient in lithotomy position.

Step 2: Speculum Insertion

Insert speculum to visualize cervix.

⚠️ Common Mistakes to Avoid:

  • Poor visualization
  • Patient discomfort

💡 Pro Tip:

Use appropriate speculum size.

Step 3: Acetic Acid Application

Apply acetic acid to cervix.

⚠️ Common Mistakes to Avoid:

  • Inadequate application
  • Wrong concentration

💡 Pro Tip:

Apply for 1-2 minutes.

Step 4: Colposcopic Examination

Examine cervix under magnification.

⚠️ Common Mistakes to Avoid:

  • Missed lesions
  • Incomplete exam

💡 Pro Tip:

Systematically examine all areas.

Step 5: Lugol Iodine Application

Apply Lugol iodine for further assessment.

⚠️ Common Mistakes to Avoid:

  • Inadequate application
  • Missed areas

💡 Pro Tip:

Assess for non-staining areas.

Step 6: Biopsy (if indicated)

Take directed biopsy from abnormal areas.

⚠️ Common Mistakes to Avoid:

  • Wrong site
  • Inadequate sample

💡 Pro Tip:

Take multiple biopsies if needed.

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Post-procedure Care

Post-procedure care involves communicating results, patient education, and scheduling follow-up as needed.

Complications & Management

Complication Incidence Signs Management Prevention
Bleeding 2-5% Spotting Pressure, silver nitrate Gentle technique
Infection 1-2% Discharge, discomfort Antibiotics Sterile technique
Pain 5-10% Cramping, discomfort Analgesics Gentle technique

Clinical Pearls

💡

Apply acetic acid for adequate time.

🎯

Systematically examine all areas.

⚡

Take multiple biopsies if needed.

🔍

Document all findings carefully.

📊

Communicate results clearly.

🎨

Provide clear post-procedure instructions.

⚠️

Schedule follow-up as needed.