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

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

3. Equipment

4. Trolley

5. 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

6. Anatomy of cervix

7. 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

8. Normal cervix

9. Lax vaginal walls

10. Cervical polyp

11. Nabothian cysts

12. Ectropian

13. Strawberry cervix (TV)

14. Suspicious cervix

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

16. Abnormal cytology

17. Histological classification

18. Aceto-white changes
Low grade ACW
High grade ACW

19. Iodine positive

20. Cervical punch biopsy

21. Excisional biopsy (LLETZ)

22. Cervix post- treatment

23. Ca cervix from a HIV patient

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

25. 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