|Colposcopy and Biopsy|
While a Pap test can show the presence of abnormal or suspicious cells, a precancerous condition (dysplasia) can only be diagnosed through the use of a colposcopy and biopsy.
Colposcopy - A colposcope is a microscope through which a health practitioner can closely examine the cervix and/or vagina. Typically, a mild vinegar solution is swabbed onto the area first, which turns abnormal areas white. Alternatively, sometimes a mild iodine solution is used, which stains the normal tissue.
Biopsy - The type of biopsy most often done at this point is called a punch biopsy, where a very small piece of tissue is snipped (with small forceps) from the part of the cervix that looks the most abnormal. This tissue is then analyzed in a laboratory. A sharp "pinch" may be felt during the biopsy, and some cramping afterwards. The cervix should heal completely from the biopsy, with no ill aftereffects.
Endocervical Curettage - sometimes a separate sample of tissue is removed from the endocervical canal (the passageway that connects the cervix to the uterus). In endocervical curettage (ECC), a spoon-shaped instrument called a curette is used to scrape tissue from the lining of the endocervical canal. This area, which contains glandular as well as squamous cells, is often difficult to see with a colposcope.
Picture of a colposcope (the part that goes inside)
What's Next? The goal of the colposcopy and biopsy is to obtain a definite diagnosis. The Possibilities:
1) Mild Dysplasia - CIN 1
2) Moderate Dysplasia - CIN 2
3) Severe Dysplasia - CIN 3
4) No diagnosis yet - need more information
5) Cervical Cancer
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