January 15, 2017 Liza Colimon, MD A colposcopy is indicated in the setting of an abnormal pap smear. If your pap smear shows any of the following abnormal findings you may need a colposcopy: Atypical squamous cells of undetermined significance (ASCUS) Low grade squamous intraepithelial neoplasia (LSIL) High grade squamous intraepithelial neoplasia (HSIL) Presence of human papilloma virus (HPV) A colposcope is used to enlarge the cervix by magnifying the cervix for the physician who is looking through the eye pieces of the scope. The vaginal skin and labia can also be examined. Colposcopy is performed so that your doctor can better visualize potentially abnormal areas. A special solution called acetic acid, which is essentially vinegar, is applied to the cervix which assists in visualizing areas of concern. If an area is identified, a biopsy will be taken to send to a pathologist for more accurate diagnosis. The goal of the procedure is to obtain a tissue sample if abnormal areas are identified because the tissue will aid the pathologist to make a more accurate diagnosis of the type of abnormal cells that exist. A biopsy will allow the physician to make a more accurate diagnosis if abnormal cells are present than can be interpreted from a pap smear alone. The procedure is performed in the office. You will be placed in the same position as when you had a pap smear and a speculum will be placed inside the vagina. The colposcope is used to magnify the cervix, and does not touch your body. If a biopsy is necessary you will be notified before it is performed. A special instrument is used to remove a less than 1 mm piece of tissue from the cervix. During the biopsy you will feel some mild cramping which should resolve within 1-3 minutes. Often times, the inside of the cervical opening will need to be sampled as well with a special instrument called an endocervical curette (ECC). You should not put anything in your vagina or have intercourse for three days prior to the procedure and for up to three days after the procedure. If you start your period prior to the procedure, it should be rescheduled. Your doctor will inform you when they feel it is safe for you to have sex after the procedure.