Rajvinder Dhillon Specialist Biomedical Scientist & colposcopist Role of colposcopy Rajvinder Dhillon Specialist Biomedical Scientist & colposcopist

What is colposcopy? “kolpos”-hollow “skopos”- examine 1925 Hinselmann-invented colposcope 1928 Schillers test 1941 Papanicolaou & Traut – cervical smears

Equipment

Trolley

Mode of action-solutions Saline- Green filter. Vascular pattern Acetic acid- coagulation of proteins on the cervix Lugols’ iodine- Schillers test. Staining of non-glycogen containing epithelium

Anatomy of cervix

Why refer to colposcopy 3rd inadequate smear mild/moderate/severe/ smear 2 week wait: ?glandular neoplasia/ ?invasive Suspicious cervix Stenosed Os Poor access Unable to locate cervix

Normal cervix

Lax vaginal walls

Cervical polyp

Nabothian cysts

Ectropian

Strawberry cervix (TV)

Suspicious cervix

Colposcopic examination Examine vulva Insert speculum Use green filter Apply acetic acid apply iodine Biopsy Treatment (LLETZ, laser, cold coagulation)

Abnormal cytology

Histological classification

Aceto-white changes Low grade ACW High grade ACW

Iodine positive

Cervical punch biopsy

Excisional biopsy (LLETZ)

Cervix post- treatment

Ca cervix from a HIV patient

FIGO staging 1a1=5mm depth 7mm (microinvasive), 1b1 <4cm, 1b2>4cm, 11b-tumour with parametrium involvement,111-hydronephrosis,1V- involves bladder & rectum.

Conclusion Give patients adequate information in simple terms Inform colposcopists of any history of abuse Encourage compliance with follow-up Refer any suspicious cervix under 2 week wait THANKYOU