Introduction to Colposcopy Flashcards
What is a colposcope?
Low power microscope to magnify the cervix
Importance of colposcopy
Women with abnormal cervical screening can be referred for diagnostic test = colposcopy & biopsy
C. Ms Chan will have colposcopy
During colposcopy, what must be identified?
During colposcopy, the colposcopist will identify the squamocolumnar junction (SCJ) and transformatoin zone (TZ)
Outline how the transformation zone forms
Why is acetic acid added during colposcopy?
Why is Lugol’s iodine added in colposcopy?
What is seen here>
Acetowhite
Mosaic and punctations
Abnormal areas did not take up iodine
- Insert speculum
- Adjust colposcppe to focus on cervix
- Clean cervix with NS
- Add acetic acid = look for acetowhite
- Add Lugol’s iodine
- Take biopsy from suspicious areas
- Stop bleeding with ???sulphate
What is done if biopsy shows a low grade lesion?
Continue regular surveillance (eg repeat smear every 6 months for 3 times)
What is done if biopsy shows a high grade lesion?
What are the risk of LEEP?
Short-term:
- Injury to surrounding structures
- Bleeding (primary or secondary), infection
Long-term:
- Increased risk of preterm births and low birthweight baby
- Cervical stenosis
How is LEEP done?
- Clean cervix with NS
- Add acetic acid to identify acetwhite lesions
- Add Lugol’s iodine to demarcate squamocolumnar junction
- Inject LA + adrenaline (reduce bleeding) at 4 quadrants of cervix
- Slice the transformation zone
- Use diathermy to achieve haemostasis
Avoid sex, swimming, bath tub for 6 weeks
Bleeding will ocur for 2-3 weeks
If bleeding is heavier than normal menses, go to A&E
Follow-up in 3 weeks to see results and check the wound
