Colposcopy is used to inspect the cervix under low
power magnification. It is used for the patient who
has a previous abnormal pap test.
The scope is pushed into the room prior to the procedure
and plugged in. There is not much room for the doctor to
maneuver the light, scope, and sit on a metal chair,
so make sure the bed is far enough away from the wall
for elbowroom.

The abnormal cells turn white when swabbed with 3% acetic acid
and can be looked at directly with the microscope.
Sometimes the cervix looks pretty good under
magnification, so biopsies may not be needed.
A repeat pap may be in done in addition to the biopsy, so set up
the tray for both. If the doctor wants to do a pap or take cultures,
it must be done before acetic acid is used in the vagina.

Click here to see instruments needed for this procedure.
The top instrument is a ring forcep and is only used occasionally.
The instrument on the left snips the biopsy,
(See internal illustration)
the tenaculum in the middle of the photo
may be used to steady the cervix,
and the endocervical dialator on the right is used to open
the os a bit to visualize how far the
abnormal patch of cells has traveled into the os.
Note that there is no room on the table for the instruments.
They are laid face down on the desk, so as to not worry the patient.
They are then opened as the doctor asks for them during the procedure.

Large q tips are used to swab the cervix with acetic-vinegar
solution. The biopsies are poked out of the instrument with
a small stick, put on a small piece of telfa, and put in the
formalin jar. It is important to listen for the "O'clock"
position of the biopsy on the cervix. You can write that on the lid.
Write name and last 4 on bottle before leaving room.

Monsel's paste must be pre-mixed to the correct consistancy
(like creamy peanut butter) and put in a little med cup prior
to the procedure. It is important to have it ready to use
because that helps to stop the bleeding from the biopsy site.
The patient is told not to worry of black discharge like coffee
grounds is seen on her panties, because this is what the monsel's
paste looks like when it is done with the job.

It is not painful afterwards, so the patient is given a pad-
for post procedure spotting, and is fine to dress and leave.
It is a bit uncomfortable when the biopsy is snipped out,
so the doctor ususally askes the patient to cough.
After a second or two it is over, but it may be repeated
for up to 3 different sites.

It is hard to not do more to comfort the patient,
but what she needs is for you to take good care
of her specimins and help the doctor by getting them safely
into their jars.

It would be nice to invent a quickie modified lamaze
breathing routine to offer, so if anyone help me invent
one, please e-mail me with your suggestions. (Smile)

Typical post procedure instructions are here.
Ususally the woman is given a follow up appt. in about 2-3
weeks to discuss the results.
Sometimes they live so far away that the result
may be given over the phone by the gynecologist, this should
be discussed before they leave so that they will be home to
take the call.

Nurses should not give results over the phone because
they are usually abnormal - otherwise, they culpo would not
have be done in the first place.