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Abnormal Pap Followup Exam
Getting the answers you need
If your pap exam shows abnormal results, your doctor may order a follow-up exam to more closely examine the cervix and vagina using a special magnifying device called a colposcope. If the colposcopy reveals an area of abnormal tissue, your doctor will take a small sample of the tissue (a cervical biopsy) to send to the lab for further evaluation.
An abnormal pap smear is the most common reason for performing a colposcopy, but this procedure is also used to diagnose and assist in the treatment of:
- Polyps (benign growths)
- Genital warts, which may indicate infection with human papilloma virus (HPV), a risk factor for developing cervical cancer
- Diethylstilbestrol (DES) exposure in women whose mothers took DES during pregnancy, as DES exposure increases the risk for cancer of the reproductive system
What to Expect
As with all your visits to About Women Ob-Gyn, we want to make sure you feel at ease, and we go above and beyond to ensure your comfort. In general, a colposcopy follows these steps:
- After undressing from the waist down and putting on a hospital gown, you will lie on an examination table, with your feet and legs supported as for a pelvic examination.
- Your physician will insert an instrument called a speculum into your vagina to spread the walls of the vagina apart to expose the cervix.
- The colposcope, which is like a microscope with a light on the end, will be placed at the opening of your vagina. The colposcope does not enter your vagina.
- Your physician will look through the colposcope to locate any problem areas on the cervix or in the vagina and photos may be taken to include in for your healthcare record.
- Your cervix may be cleansed and soaked with a vinegar solution, also called an acetic acid solution, which may cause a mild burning sensation. This solution causes any abnormal tissues to turn white and become more visible. In addition, an iodine solution may be used to coat the cervix and expose abnormal tissue. This is called the Schiller test.
- Your physician may take a small tissue sample called a biopsy. The physician will numb the area first, but you may feel a slight pinch or cramp as the tissue is removed.
- Cells from the inside of the cervical canal may be sampled with a special instrument called an endocervical curette. This may also cause some cramping.
- Bleeding from the biopsy site may be treated with a medication cream or with a pressure dressing.
- The tissue will be sent to a lab for examination and we will notify you of the results.
After the Procedure
- We will provide you with detailed instructions after your colposcopy procedure.
- You may want to wear a sanitary pad for bleeding. If a biopsy was performed, it is normal to have some mild cramping, spotting, and dark or black-colored discharge for several days. The dark discharge is from the medication applied to your cervix to control bleeding.
- You may take a pain reliever for cramping or soreness as directed by your physician. Aspirin or certain other pain medications may increase the chance of bleeding, so be sure to take only recommended medications.
- If a biopsy was performed, you may be instructed not to douche, use tampons, or have intercourse for one week after the procedure, or for a period of time recommended by your physician.
- You may also be asked to avoid strenuous activity or heavy lifting.
- You may resume your normal diet unless your physician advises you differently.
- Your physician will advise you on when to return for further treatment or care. Generally, women who have had a cervical biopsy will need more frequent Pap tests.
Notify your physician if you have any of the following:
- Foul-smelling drainage from your vagina
- Fever and/or chills
- Severe pelvic (lower abdominal) pain
Even if you receive your routine gynecology care from your family doctor or other healthcare provider, we encourage you to contact About Women Ob-Gyn for specialized gynecology services, including: