A colposcopy-directed biopsy uses a low-powered microscope called a colposcope to help the doctor view the surface of the cervix and show abnormalities.

This procedure is usually done after a positive Pap smear to identify the abnormality. If any areas look abnormal, a small sample of the tissue will be removed (biopsy) using small biopsy forceps. Many samples may be taken, depending on the size of the area.

The test also may be done if an abnormal Pap smear shows signs of cervical dysplasia. The colposcopy may also be used to keep track of precancer cells and look for abnormalities that come back after treatment.

If the colposcopy or biopsy does not show why the Pap smear was abnormal, your doctor may suggest that you have a more extensive biopsy.

Abnormal findings during a colposcopy include:
  • Abnormal patterns in the blood vessels
  • Whitish patches on the cervix
  • Areas that are swollen, worn away, or wasted away (atrophic)
A smooth, pink surface of the cervix is normal. Any of these problems may be signs of cancerous changes.

Abnormal results may indicate:
  • Precancerous tissue changes
  • Cervical intraepithelial neoplasia
  • Cervical warts (human papilloma virus)
  • Cancer
There is no special preparation. You may be more comfortable if you empty your bladder and bowel before the procedure. You should not douche or have sexual intercourse for 24 hours before the exam.

A colposcopy is painless, although some women feel a slight sting from the vinegar solution. The biopsy may feel like a pinch each time a tissue sample is taken. You may have some cramping after the biopsy.

It is typical for women to hold their breath during pelvic procedures because they expect pain. Concentrating on slow, regular breathing will help you relax and help relieve pain.

After the biopsy, you may have some bleeding for up to a week. To allow the biopsy area to heal, for two weeks avoid:
  • Douching
  • Sexual intercourse
  • Using tampons
Call your doctor immediately if bleeding is very heavy or lasts for longer than two weeks or if you notice any signs of infection (fever, foul odor, or discharge)