Colposcopy and punch biopsy

Question 1

What is colposcopy?

Answer 1

Diagnostic procedure obtaining a magnifiec view of the cervix to examine transformation zone and detect malignant/premalignant conditions.

Question 2

What are the indications of colposcopy?

Answer 2

Severe or moderate dyskeratosis / glandular neoplasia on smear, borderline change seen 2x, 3x inadequate smear, clinical suspicion.

Question 3

What is the procedure of colposcopy?

Answer 3

1. Lithiotomy position
2. Cusco’s speculum identify cervix. Examine at low power.
3. Saline soaked wool applied and blood vessels examined
4. Avetic acid to cervix. CIN = white (acetowhite)
5. Schiller’s test: Lugol iodine applied. Negative if staining drak brown, positive if no uptake.
6. Biopsy if abnormality seen.
7. Treatment can be given under LA: ablation by cyro or cold coagulation if low grade disease, or excision techniques (LLETZ)

Question 4

What are the adv/ disadv of colposcopy?

Answer 4

Adv: Rapid, no anaesthesia, low risk of cmx

Disadv: Unpleasant, risk of tx with infeciton and bleed, FU necessary, overtreating CINI (50% regression rate)

Question 5

What are the complications of colposcopy?

Answer 5

Complications

Few after coloposcopy. Some from excision (bleeding and infeciton)

Prognosis

Success rate of local tx 85%.

Question 6

What is a cervical punch biopsy?

Answer 6

Cervical punch biopsy – small amount of tissue removed from the cervix