colposcopy

Colposcopy is a direct observation of the vaginal and vaginal epithelium 10-40 times by a colposcope under a strong light source to observe small lesions that are invisible to the naked eye, and to perform local biopsy at suspicious sites to improve cervical disease. The rate of diagnosis. Sexual intercourse was prohibited for the first three days of the examination. The examination should be 3-7 days after the menstrual cleansing. The leucorrhea should be checked before surgery, and no vaginitis can be diagnosed before biopsy can be performed. Basic Information Specialist classification: gynecological examination classification: endoscope Applicable gender: whether women are fasting: not fasting Tips: Inappropriate people: normal values ​​for menstruating women The squamous epithelium of the normal cervicovaginal area is smooth and pink. The epithelium does not change color after 3% acetic acid is applied. The iodine test was positive. Clinical significance Abnormal result Cervical vaginal columnar epithelium: The columnar epithelium in the cervical canal is moved down, replacing the squamous epithelium of the cervix, which is called cervical erosion. The surface of the naked eye is seen as a fluffy, reddish color. After 3% acetic acid application, it swollen quickly and became grape-like. The iodine test was negative. Transformation zone: a region in which the squamous epithelium intersects with the columnar epithelium, containing a neonatal squamous epithelium and a columnar epithelium that has not been replaced by a squamous epithelium. Colp-like capillaries are seen under colposcopy; grape islands formed by the epithelium surrounding the columnar epithelium; glandular openings opening in the metaplastic epithelium and retention cysts (cervical gland cysts) covered by metaplastic epithelium. After the application of 3% acetic acid, the metaplastic epithelium was significantly contrasted with the columnar epithelium in the circle. After iodine application, the iodine coloration is different. The pathological examination was squamous metaplasia. Abnormal colposcopy image: iodine test is negative, including (1) The white epithelium is white after application of acetic acid, with clear boundaries and no blood vessels. Pathological examination may be metaplastic epithelium and dysplasia. (2) White spotted white patches with rough surface and no blood vessels. It can also be seen without applying 3% acetic acid. Pathological examination is hyperkeratosis or parakeratosis, sometimes HPV infection. There may be malignant lesions in or around the leukoplakia, and a biopsy should be performed routinely. (3) The dot structure is formerly known as the white spot substrate. Whitened with 3% acetic acid, the boundary is clear, the surface is smooth and there are very fine red spots (pointed capillaries). Pathological examination may have dysplasia. (4) Mosaic irregular blood vessels divide the white epithelium with 3% acetic acid and accumulate into small blocks with clear boundaries and irregular shapes, just like the patterns of red thin lines. If the surface is irregular, the blood vessels are pushed to the periphery, suggesting that the cells are hyperplastic, and attention should be paid to cancer. Pathological examination is often dysplasia. (5) Shaped blood vessels refer to the diameter, size, shape, branch, direction and arrangement of blood vessels are extremely irregular, such as spiral shape, comma shape, hairpin shape, leaf shape, line sphere, and bayberry shape. Pathological examinations are mostly cancerous to varying degrees. Early cervical cancer: Under the strong light, the surface structure is unclear, showing clouds, cerebral gyrus, lard, and the surface is pinned or slightly depressed. Local vascular abnormal hyperplasia, lumen enlargement, loss of normal blood vessel branching, widening mutual distance, special disordered shape, can be changed into a shape of a scorpion, a stick, a hairpin, a spiral or a pompon. After applying 3% acetic acid, the surface is glassy edema or cooked meat, and often has a profiled epithelium. The iodine test was negative or very lightly colored. People who need to be examined: genital itching, or burning discomfort, pain in the lower abdomen or lumbosacral region, each time during sexual intercourse, menstruation and defecation. There are also people who are conscious of both lower limb weakness, mouth pain, nausea, yellow urine and other symptoms. Precautions Pre-inspection contraindications: sexual intercourse is prohibited for the first three days of the examination. The examination should be 3-7 days after the menstrual cleansing. The leucorrhea should be checked before surgery, and no vaginitis can be diagnosed before biopsy can be performed. Do vaginal washing for the first three days of gynecology. A few days before the check, pay attention to diet, do not eat too much greasy, not easy to digest food, do not drink alcohol, do not eat drugs that damage the liver and kidney function. Requirements for examination: The site of biopsy may be bleeding, so do not have sexual intercourse, vaginal lavage or bathing within 1 to 2 weeks after the examination. When vaginal bleeding is frequent, you should go to the hospital for treatment. Inspection process 1, before the examination should have vaginal cell smear test results, except for Trichomonas vaginalis, Candida, gonococcus and other inflammation. Avoid vaginal washing, double consultation and sex life 24 hours before the test. 2, the patient took the bladder cut-off position, fully exposed the cervicovaginal part with a vaginal speculum, and gently wiped the cervical secretions with a cotton ball. To avoid bleeding, do not rub with force. 3. Open the beginning of the illumination, adjust the objective lens to the same level as the part to be inspected, and adjust the focal length (the general object distance is about 20cm from the object to be inspected), and adjust to the object image. First, under the white light, use a 10 times low power microscope to roughly observe the site to be examined. Taking the cervix as an example, the shape, color and blood vessels of the cervix can be roughly observed. 4. Rub the cervicovaginal part with 3% acetic acid cotton ball to purify and swell the epithelium. Observe the boundary of the lesion and its surface morphology. When it is necessary to observe for a long time, repeat 3% acetic acid every 3-5 minutes. once. A green filter lens should be added for precise observation of the blood vessel and magnified 20 times. Finally, the compound iodine solution (30 g of iodine, 0.6 g of potassium iodide, and 100 ml of distilled water) was applied, and the biopsy was taken for pathological examination in the negative area of ​​the iodine test or the suspected lesion. Not suitable for the crowd Inappropriate people: menstruating women. Adverse reactions and risks Nothing.

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