Akademik

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Examination of vagina and cervix by means of an endoscope. [colpo- + G. skopeo, to view] C. is used chiefly to identify areas of cervical dysplasia in women with abnormal Pap smears and as an aid in biopsy or excision procedures including cautery, cryotherapy, laser vaporization, and loop electrosurgical excision. The colposcope is a stationary instrument with self-contained lighting and magnification adjustable from 2× to 20× or higher. It is used in conjunction with a standard vaginal speculum to view the cervix, particularly the transformation zone, and the vaginal mucosa. A green filter enhances visualization of blood vessel s and identification of abnormal (punctate, mosaic, or atypical) vascular patterns. Application of 5% acetic acid solution accentuates areas of increased cellular protein and increased nuclear density, which are likely to represent zones of squamous cell change. Lugol solution (iodine-potassium iodide), which stains only squamous epithelial cells that have a normal glycogen content, may also be applied to delineate abnormal squamous epithelium. Colposcopically directed cervical biopsy is the procedure of choice following a Pap smear showing atypical squamous cells of uncertain significance, low-grade or high-grade squamous intraepithelial lesions, koilocytosis, carcinoma in situ, or higher grade carcinomas.