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Colposcopy - the advanced approach for cervical cancer screening

Dr. Ivet Raicheva


Dr. Raicheva graduated from Medical Faculty of the Medical University of Sofia in 1985. In 1991 she acquired her specialty in Obstetrics, Gynecology and Reproductive Medicine. The same year she started to work at SBALAG "Maichin Dom", Sofia - the largest hospital in Obstetrics and Gynecology in Bulgaria.


Dr. Raicheva has a vast clinical experience as an obstetrician-gynecologist and a strong interest in clinical gynecology, colposcopy, prenatal care and delivery.


Dr. Raicheva has joined the team of specialists at MC MARKOVS in 2022.

What is colposcopy?

Colposcopy is a diagnostic method used in gynecology to examine the cervix, vaginal walls and external genitalia. A special device called colposcope is used and the procedure is done by a highly qualified Gynecologist. The optical zoom obtained through the colposcope reveals details and structures that are normally invisible to the naked eye.


Why is colposcopy performed?

Cervical cancer is one of the most common malignant disease in women and is usually caused by the so-called human papilloma virus (HPV). The frequency of HPV infections is highest in the age group between 16-20 years. HPV infection is usually sexually transmitted, with a lifetime risk of over 75-80%.


There are two screening tools used in Gynecology to determine the risk for cervical cancer - Pap smear and colposcopy.


The distinction between normal and benign findings in the epithelium of the cervix can be relatively easily done by colposcopy. In all cases with suspicious lesions additional histological examination is performed. Colposcopy is an affordable and highly effective screening method for early detection of precancerous lesions and cancer of the cervix.


Before performing colposcopy…

According to the American College of Obstetricians and Gynecologists (ACOG), approximately 24 hours before colposcopy the following should be avoided:

  • Vaginal medications
  • Sexual intercourse
  • Usage of vaginal tampons
  • Vaginal shower

What to expect during the procedure?

Colposcopy is performed transvaginally, usually in the first clean days after the last menstrual period with a special device called colposcope. A speculum (an instrument for visualizing the cervix) is first inserted in the vagina. Once adequate visualization of the cervix is obtained, your Gynecologist will place the colposcope near the opening of the vagina. This is followed by evaluation of the surface cell layers of the exocervix.

In all cases of abnormal findings a targeted biopsy is made. The resected tissue is sent for detailed histological examination by a pathologist in a specialized laboratory. Your doctor will provide detailed explanation about the nature of the procedure and you will have to sign an informed consent.


Recovery period

Diagnostic colposcopy is performed during the standard gynecological prophylactic examination and does not require an additional recovery period. Immediately after the procedure the patient can return to normal every day activities. The targeted biopsy requires a few minutes for recovery and vaginal spotting can be expected within 1-2 days after the procedure. If necessary a consultation with your Gynecologist is scheduled.


How often is colposcopy performed?

Colposcopic follow-up for cervical cancer prevention is recommended once a year in low-risk patients. In selected cases more frequent check-ups are required.

Different countries have different recommendations regarding the frequency of colposcopic follow-up. This is related to the prevalence of HPV, the percentage of the population vaccinated against HPV, economic status, etc.


Is colposcopy safe during pregnancy?

Diagnostic colposcopy during pregnancy is completely safe. However, it is important to emphasize that the colposcopic findings may significantly change during pregnancy and more often there may be indications for biopsy. Targeted biopsy and conization during pregnancy should be performed with extreme caution. In selected cases dynamic colposcopic monitoring of the cervix during pregnancy by a highly qualified Gynecologist can be discussed.