Colposcopy

Colposcopy is a special diagnostic procedure. The usual reason for doing a colposcopy is to rule out cervical cancer after an abnormal Pap smear. The abnormal Pap smear may have a diagnosis such as dysplasia (pre-cancerous cells, also called cervical intraepithelial neoplasia (CIN) or low/high grade squamous intraepithelial lesion (LGSIL or HGSIL)); atypical squamous cells of undetermined significance (ASCUS); atypical glandular cells of undetermined significance (AGCUS); atypia. Other reasons for doing a colposcopy are to examine the cervix, vagina, and vulva for genital warts (condylomata) or human papilloma virus (HPV).

Our very experienced, board-certified OB/GYN with special expertise in colposcopy will carefully examine the cervix with a colposcope, which is basically a specialized microscope that magnifies the cervix. The gynecologist applies a solution of acetic acid to wash the cervix and uses a special green filter on the colposcope to highlight any abnormal areas on the cervix. The entire outer part of the cervix (ectocervix) is carefully and methodically examined with the colposcope. The entire transformation zone (the area bordering the outer and inner parts of the cervix where columnar cells have transformed into squamous cells during the process of squamous metaplasia) must be visualized in order for the colposcopy to be deemed "satisfactory"; if the colposcopy is unsatisfactory, then the patient must undergo a diagnostic conization of the cervix, a surgical procedure. By careful observation of the transformation zone of the cervix, abnormal areas are identified by certain characteristics such as aceto-white, mosaicism, punctation, and abnormal vessels.

Any abnormal areas are biopsied by removing a tiny sample of the cervix with a special cervical punch biopsy instrument, unless the patient is pregnant, when biopsies are usually avoided unless there is a strong suspicion of invasive cancer.

The cervical canal is gently scraped with a special endocervical curette to sample for any abnormal cells that may be inside the cervical canal and out of sight from the colposcope.

While examination with the colposcope itself is painless, the cervical punch biopsies can cause some pinching pain and mild temporary cramping pain similar to severe menstrual cramps. This pain can be relieved with over-the-counter pain relievers such as acetominophen (Tylenol), ibuprofen (Advil, Nuprin, Motrin), or naproxen sodium (Aleve). There is some mild bleeding associated with the biopsies that is readily controlled with application of ferric subsulfate (Monsel's solution) or other means by the gynecologist. Patients may notice a brownish discharge or light spotting afterwards for several days.

After the colposcopic cervical punch biopsy, it is recommended to avoid sex, tampons, and douching for one week.

Patients should return to the office two weeks after the colposcopy to discuss the results and to plan any further tests or treatment that may be necessary, such as cryosurgery or LEEP.

Please call 718-888-0018 to schedule an appointment.

Cryosurgery

Cryosurgery of the cerivx is a gynecological procedure that uses nitrous oxide to freeze the abnormal cells on the cervix. This can effectively cure the abnormal area on the cervix by killing the abnormal cells. Our doctor is a very experienced, board-certified OB/GYN with special expertise in cryosurgery.

Prior to perfroming the cryosurgery, a colposcopy must be performed to rule out invasive cervical cancer and to determine the extent of the abnormal area of the cervix. During the cryosurgery, the gynecologist will select a cryosurgery probe and use nitrous oxide to freeze the abnormal cells on the cervix. Two freeze cycles, separated by a thawing cycle, are performed. The extent of the area to be treated is determined by the extent of the area of abnormal cells as visualized by colposcopy.

This procedure is fairly painless and does not require anesthesia.

After the cryosurgery, it is recommended to avoid sex, tampons, and douching for two weeks.

Patients should have a follow-up colposcopy and Pap smear 4 months after the cryosurgery, after which they should have Pap smears every 4-6 months until 3 consecutive Pap smears are normal or for a minimum of two years.

Please call 718-888-0018 to schedule an appointment.

Loop Electrosurgical Excision Procedure, LEEP, or Large Loop Excision of the Transformation Zone, LLETZ

Loop Electrosurgical Excision Procedure, LEEP, or Large Loop Excision of the Transformation Zone, LLETZ, is a special surgical technique used for diagnosis and treatment of cervical dysplasia (pre-cancerous cells). This can effectively cure the abnormal area on the cervix by surgically removing all the abnormal cells. Our doctor is a very experienced, board-certified OB/GYN with special expertise in LEEP.

Prior to perfroming the LEEP, a colposcopy must be performed to rule out invasive cervical cancer and to determine the extent of the abnormal area of the cervix. During the LEEP, the gynecologist will use electrosurgery and a special thin wire loop to excise or remove the superficial layer of the cervix containing the abnormal cells. The extent of the area to be removed is determined by the extent of the area of abnormal cells as visualized by colposcopy. After the layer of abnormal cells is removed, the treated area (base) is coagulated with a special ball electrode to help prevent bleeding. Ferric subsulfate (Monsel's solution) is then applied to this base, and bleeding is thoroughly controlled.

This procedure can be done under local anesthesia (awake), conscious sedation, or general anesthesia (asleep).

After the LEEP, it is recommended to avoid sex, tampons, and douching for two weeks.

Patients should return to the office two weeks after the LEEP to discuss the results of the LEEP and to plan any further tests or treatment that may be necessary.

Patients should have a follow-up colposcopy and Pap smear 4 months after the LEEP, after which they should have Pap smears every 4-6 months until 3 consecutive Pap smears are normal or for a minimum of two years.

Please call 718-888-0018 to schedule an appointment.

Our physicians are very experienced, New York State-licensed and board-certified OB/GYN physicians with special expertise in colposcopy, cryosurgery, and LEEP. They maintain hospital privileges at local hospitals including New York Hospital Medical Center of Queens, Flushing Hospital Medical Center, and New York Methodist Hospital.