Colposcopy: Direct Visualization of the Cervix for Abnormality Detection

Colposcopy (often misspelled "kolposcopy") is a diagnostic procedure using a colposcope (lighted magnifying instrument) to examine the cervix, vagina, and vulva after an abnormal Pap test or positive HPV result.

Procedure

1. Speculum inserted to visualize cervix.
2. Acetic acid (3–5%) applied → acetowhite lesions highlight dysplasia.
3. Lugol's iodine (Schiller's test) applied → normal glycogenated epithelium stains brown; abnormal areas remain pale (iodine-negative).
4. Biopsy taken from suspicious areas.

Indications

• ASC-US/ASC-H, LSIL, HSIL, AGC on cytology
• HPV 16/18 positive
• Persistent high-risk HPV
• Visible lesion

Outcomes

Guides management: observation vs. excision (LEEP, cone, cryo). Critical for cervical cancer prevention.