What is a colposcopy? Is a biopsy always necessary?

A colposcopy is the examination of the skin and mucous membranes of the lower genital tract with the use of a colposcope. The colposcope is a low-powered microscope that offers a powerful light source and multiple levels of magnification.

The usual reason women are referred for colposcopy is the discovery of abnormal cells on a Pap smear. Other indications for referral are: examination of the entire female lower genital tract in search of premalignant lesions, pre-operative planning and post-operative follow-up (surgery for HSIL or cancer).

If the treating physician finds it necessary, biopsies are performed. The lesions to be biopsied, are identified based on certain morphological features on the surface of the epithelium, and the most suspicious looking area is chosen for the biopsy. Special forceps are used for biopsies which cause no discomfort. The tissue collected is sent to a laboratory for histological examination.