Last updated: 02/17/2009

Colposcopy is usually performed in a physician's office and is similar to a regular gynecologic exam. An instrument called a speculum is inserted to hold the vagina open, and the gynecologist looks at the cervix and vagina using a colposcope, a low-power microscope designed to magnify the cervix 10–40 times its normal size. Most colposcopes are connected to a video monitor that displays the area of interest. Photographs are taken during the examination to document abnormal areas.

The colposcope is placed outside the patient's body and never touches the skin. The cervix and vagina are swabbed with dilute acetic acid (vinegar). The solution highlights abnormal areas by turning them white (instead of a normal pink color). Abnormal areas can also be identified by looking for a characteristic pattern made by abnormal blood vessels.

If any abnormal areas are seen, the doctor will take a biopsy of the tissue, a common procedure that takes about 15 minutes. Several samples might be taken, depending on the size of the abnormal area. A biopsy may cause temporary discomfort and cramping, which usually go away within a few minutes. If the abnormal area appears to extend inside the cervical canal, a scraping of the canal may also be done. The biopsy results are usually available within a week.

If the tissue sample indicates abnormal growth (dysplasia) or is precancerous, and if the entire abnormal area can be seen, the doctor can destroy the tissue using one of several procedures, including ones that use high heat (diathermy), extreme cold (cryosurgery), or lasers. Another procedure, called a loop electrosurgical excision (LEEP), uses low-voltage, high-frequency radio waves to excise tissue. If any of the abnormal tissue is within the cervical canal, a cone biopsy (removal of a conical section of the cervix for inspection) will be needed.