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A colposcopy-directed biopsy is performed using a colposcope to aid in the viewing of the surface of the cervix. It also helps to identifiy areas on the surface which show tissue abnormalities. A colposcope is a low-power microscope used to magnify the surface of the cervix 10 to 40 times its normal size (see also "Cervical biopsy").

How the Test is Performed

As in a regular pelvic examination, you will be asked to lie on your back with your feet in the stirrups. A speculum (an instrument used to hold open the birth canal in order to view and examine the cervix) will be inserted into your vagina and opened slightly.

The cervix is then swabbed with a chemical solution (acetic acid) to remove the mucus that covers the surface and help highlight abnormal areas. The colposcope is then positioned at the opening of the vagina, and the area is thoroughly examined. Photographs may be taken.

Any abnormal areas will have a small sample of the tissue removed (biopsy) using small biopsy forceps. Many samples may be taken, depending on the size of the area.

How to Prepare for the Test

There is no special preparation. The procedure may be more comfortable if you empty your bladder and bowel beforehand. You should not douche or have sexual intercourse for 24 hours before the exam.

How the Test will Feel

A colposcopy is painless. Some women feel a slight stinging sensation caused by the vinegar solution. The biopsy may feel like a pinch each time a tissue sample is taken and may have some cramping with it.

Any pain or cramping occuring during the biopsy may be helped by relaxing and taking a few slow deep breaths. Some cramping may occur after the biopsy. Many women have a tendency to hold their breath during pelvic procedures in anticipation of pain. Making an effort to concentrate on slow, regular breathing will help you relax and reduce or eliminate some pain.

Why the Test is Performed

This is usually performed after a positive pap smear to help identify the abnormality.

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