Abnormal or inconclusive pap smears
If you have an abnormal or inconclusive pap smear, your gynecologist may advise you to have a colposcopy. A colposcopy allows the physician to learn a more about what is abnormal. About 3% of all women have abnormal or inconclusive pap smears and require a colposcopy.

Colposcopies
When you have a report of a inconclusive or abnormal Pap smear, you are advised to have a colposcopy for further evaluation. About 3 % of women experience abnormal or inconclusive pap smears sometime in their life. This percentage has increased in the last few years because improved technology picks up more abnormalities.

What is a colposcopy?
Our specially trained physicians use an instrument called a "colposcope" to examine your cervix carefully. Similar to the microscope, the colposcope is attached to a floor stand and uses a powerful beam of light to magnify the cervix. By using the colposcope, your doctor can locate any suspicious areas on the surface of the cervix that are not visible to the naked eye.
Your doctor will then take small tissue samples (biopsies) from the suspicious areas. The specimens are sent to the pathology laboratory for processing and evaluation. When the doctor gets the results from the lab, you will be contacted to discuss the report and advised treatment.

Does it hurt?
Although there is no pain associated with the colposcopic examination, taking a small sample of the cervix causes discomfort. The discomfort is generally minimal and lasts only a few minutes One of the biopsies includes going into the cervical canal and can cause cramps.

Are there any complications after a colposcopy?
Possible complications associated with colposcopies are rare. The patient will have vaginal spotting of blood for a few days. Rarely, patients bleed heavier than a menstrual period within a few hours after the biopsy. If excessive bleeding (more than one sanitary napkin per hour) occurs, contact your physician.

Will I be restricted in my activities after a cervical biopsy?
You can carry on normal activities, although you should avoid intercourse for 14 days while the cervix is healing.

Your Diagnosis
The majority of patients having a colposcopy have a final diagnosis of either "mild to moderate dyplasia" or "normal" cervix. A few patients will have a diagnosis of carcinoma-in-situ.

1. Moderate Dyplasia
"Mild to moderate dyplasia" is the earliest change that is not normal in the cells within the surface layer of the cervix. It has a potential, if left untreated, of progressing to a more sever change after several years.

Treatment:
The majority of patients with "mild to moderate" dysplasia can be treated with cryosurgery. Cryosurgery is a method of freezing the cervix and takes about ten to fifteen minutes. Because the abnormal cells are found in the surface layers of the cervix, the freezing technique destroys the surface layer, which is then cast off. The cervix will produce a new surface layer of normal cells.
Think of freezing as similar to a burn of the skin on the hand (without any pain). The surface layer is destroyed and cast off like a blister; then a new "skin" replaces the old. In 10 to 20% of the cases, a second treatment is necessary if the abnormalities persist.

Is cryosurgery painful?
Generally not. It can cause mild cramping and occasionally may be accompanied by a temporary feeling of lightheadedness and flushing.

Are there any after effects of cyrosurgery?
You will have a very watery vaginal discharge for two to six weeks. This may be tinged with some blood. It helps to use sanitary napkins for the first few weeks. However, cryosurgery will not affect your menstrual cycle or cause infertility. Complete healing of the cervix takes about three months.

Are there any restricted activities?
You can carry out your normal activities; however, you should avoid intercourse or douching for at least two weeks during the period of heavy watery discharge. The cervix is undergoing a healing process. Irritation to the area could result in bleeding.

2. What is carcinoma-in-situ?
Carcinoma-in-situ is a condition more advanced than severe dysplasia. It is a more advanced lesion, affecting the cells within the surface layer of the cervix. It does not mean invasive cancer. However, if left untreated, it has the potential to develop into cancer.

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