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Colposcopy
A colposcopy is a procedure used to magnify the surfaces of the cervix and vagina through a lighted, magnifying instrument called a colposcope. This procedure is usually done when a physician finds something visible on exam that needs further investigation or as a follow-up to an abnormal pap smear.
The colposcope magnifies the view 2 to 60 times, allowing the physician to view abnormalities that may be missed by the naked eye. A camera sometimes is attached to the colposcope to take pictures of the vagina and cervix to be placed in the medical records.
The Procedure:
The process is very similar to your yearly Pap test. You will be asked to lie an exam table with your feet in stirrups. A speculum will be used to spread the vaginal walls. Your physician will apply a solution to the vagina and cervix with a swab. This makes any areas of abnormal cells more visible.
If any biopsies are taken during the procedure, the cells can be viewed under a microscope to determine any abnormalities that may be cancerous.
Post Procedure:
There are no special instructions following a colposcopy. If a biopsy was taken, your physician will give you further instructions.
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Endometrial Biopsy
An endometrial biopsy is a procedure done in the office to obtain a small amount of tissue from the lining of the uterus. The tissue is then examined under a microscope by a pathologist to look for any abnormal calls.
The procedure is usually indicated when a woman has abnormal uterine bleeding or bleeding after menopause
The Procedure:
- You may take ibuprofen 400 mg. one hour before your appointment if you desire.
- You will be positioned on the exam table in the same position that you are for a pap smear.
- The doctor or nurse practitioner will examine the size and position of the uterus and a speculum will be placed in the vagina to visualize the cervix.
- The cervix will be cleaned with a betadine solution. A topical anesthetic may be applied.
- A tenaculum (instrument) may be applied to the cervix to stable the position of the uterus.
- A small catheter will be inserted through the cervix into the uterine cavity to obtain a tissue sample. You may experience uterine cramps while the tissue sample is being obtained.
- The specimen is sent to a pathologist for evaluation and the results are sent to us within 7 days
Post Procedure:
The cramping should subside shortly after the procedure but you may take ibuprofen if you need to. You may have light spotting or bleeding for a day or two.
Call 765.448.8000 if you experience severe pain, heavy bleeding, or fever.
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LEEP (Loop Electrosurgical Excision Procedure)
Overview:
LEEP is a surgical procedure used to cut away abnormal tissue from the cervix. It uses a low voltage electrified thin wire loop that cuts away the abnormal tissue.
The cervix is made up of a thin layer of tissue. This tissue grows all the time and continually sheds old cells and grows new cells. Sometimes, these cells can change and become abnormal. This condition is called dysplasia. If dysplasia is severe or does not go away, the cells can lead to cancer of the cervix. A routine pap test, a coloscopy or a cone biopsy can detect these abnormal cells.
Treating Dysplasia:
Abnormal cells can be removed from the cervix with LEEP. This allows the healthy cells underneath to grow and replace the abnormal cells. Dysplasia can also be treated by cryosurgery, laser or cone biopsy. Your physician will help you make the decision on which procedure is best for you.
The Procedure:
Leep is usually done at your providers office. Certain conditions may require you to go to a hospital. You should bring someone with you to drive you home. This procedure normally takes about 30 minutes.
You will be taken to a procedure room and asked to lie on your back on an exam table and place your legs in stirrups. There will be a nurse, an assistant and the physician in the room during the procedure.
A speculum will be inserted into your vagina. The speculum will spread the vaginal walls apart, allowing the physician to examine the cervix. A solution is applied to your cervix to better visualize the abnormal cells. A colposcope will be used to magnify the cervix for better visualization. Your cervix will be numbed with an injection of local anesthetic. You will remain awake during the procedure; you may feel some dull aching or cramping.
The thin wire loop will then be used to cut away a thin layer of tissue from the cervix. An electric current is passed through the loop to enable it to act like a scalpel. There are different sizes and shapes of the loops, your physician will choose one that best works for you.
After the excision, a special paste will be applied to stop any bleeding. The tissue that is removed will be sent to a lab for analysis.
Risks:
LEEP is a very safe procedure with minimal risks. Some complications that are rare but can occur include:
- Cervical bleeding. Electrocautery may be used to control any unexpected bleeding.
- Risk of infection. Your physician will give you instructions to decrease your risk of infection.
- Abdominal pain and cramping.
- Rarely injury from electrical current used.
Post Procedure:
Follow the instructions given to you by your physician to ensure a normal recovery.
- Mild cramping may occur for several hours after the procedure.
- A dark brown vaginal discharge during the first week is normal (from the paste used).
- Vaginal discharge or spotting may occur for about 3 weeks.
- Do no insert anything into the vagina for 3 weeks.
- Sexual intercourse should be avoided for about 3-4 weeks.
- Refrain from vigorous exercise for 3-4 weeks.
When to Call Your Health Care Provider:
Call your physician if you experience any of these symptoms:
- Vaginal bleeding that lasts longer than 1 week.
- Bleeding that is heavier than your normal period.
- Increasing abdominal pain.
- Bad smelling, yellowish vaginal discharge (may indicate an infection).
- Fever (>100.4° F)
Follow Up:
A Pap test should be repeated every 4 to 6 months or as recommended by your health care provider. Once several tests are normal, you may extend your exams to every year or as recommended by your provider.
Glossary of Terms:
Cervix: The lower, narrow end of the uterus, which protrudes into the vagina
Colposcope: Viewing of the cervix, vulva, or vagina under magnification with an instrument called a coloscope
Cone Biopsy: Surgical removal of cone shaped wedges of cervical tissue
Cryosurgery: A freezing technique used to destroy diseased tissue: also known as "cold cautery"
Dysplasia: A noncancerous condition that occurs when normal cells on the surface of the cervix are replaced by a layer of abnormal cells. Dysplasia is classified as mild, moderate, or severe
Electrocautery: A procedure in which an instrument works with electric current to destroy tissue
Laser: A small, intense beam of light used as a surgical tool
Speculum: An instrument used to spread the walls of the vagina so that the cervix can be seen
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Obstetrical Ultrasound
Overview:
In the 21st century, the Obstetrical ultrasound has provided a means for real time evaluation of pregnancy with an accuracy and clarity previously unavailable. At Arnett Clinic, real time ultrasound using a full time ultrasonographer with images evaluated by your obstetrician is available.
First Trimester:
In the first 12 weeks of pregnancy your doctor can use an ultrasound to confirm the due date, evaluate a threatened miscarriage, diagnose twins or higher multiple gestations, and evaluate possible ectopic pregnancy. Furthermore, a first trimester scan can be used to evaluate for some possible birth defects including Down syndrome.
Second Trimester:
By twenty weeks the fetus is formed and a full anatomical scan can provide new and useful information on your baby’s development. Along with the anatomical scan the 20 week ultrasound provides an estimate of growth for the first half of the pregnancy and an excellent view of the amniotic fluid, the umbilical cord and the placenta.
Third Trimester:
In the final stage of pregnancy the ultrasound becomes important in evaluating the status of certain pregnancies. It can be used to monitor previously diagnosed problems with growth and anatomy. Your physician will also use the ultrasound to evaluate the position and orientation of the fetus, to check for possible rupture of membranes, and to test for fetal wellbeing.
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