You will be asked to lie on your back with your feet in the stirrups. As in a regular pelvic examination, a speculum (an instrument used to hold the vaginal canal open in order to examine the interior) will be inserted into the vagina and opened slightly so that the cervix is visible. The area is then viewed with a colposcope, a small low-power microscope used to magnify the surface of the vagina and cervix (the most accurate method). The cervix is swabbed with a vinegar solution (acetic acid), which removes the mucus to help highlight abnormal areas. The colposcope is then positioned at the opening of the vagina and the area is examined. Photographs may be taken. An alternative method is the Schiller's test, which uses an iodine solution to stain the cervix. The stain is inserted through the speculum. The iodine solution stains the normal portions of the cervix, but does not stain abnormal tissues. When an abnormality is located, a sample (biopsy) may be taken using a small biopsy forceps or a large needle. More than one sample may be taken. Cells from the cervical canal may be used as samples as well. This is called an endocervical curretage or biopsy (ECC) and may futher help identify and locate abnormal cervical cells. When the procedure is completed, all the instruments are removed. |