What is a Colposcopy Biopsy? (with pictures)

Lindsay Kahl
Lindsay Kahl
Tissue from a woman's cervix is removed in a colposcopy biopsy.
Tissue from a woman's cervix is removed in a colposcopy biopsy.

A colposcopy biopsy is a diagnostic procedure in which a doctor removes tissue samples from the cervix in order to examine them. During this process, the doctor uses a special magnifying tool called a colposcope. Using this, the doctor is able to visually examine the cervix to identify possibly abnormal tissue. A colposcopy biopsy is an important tool in the detection and prevention of cervical cancer.

A woman with an abnormal pap smear may need to get a colposcopy biopsy.
A woman with an abnormal pap smear may need to get a colposcopy biopsy.

A gynecologist might suggest a colposcopy biopsy if a woman has abnormal Pap test results. An abnormal Pap test might be the result of an infection, which can lead to cervical cancer, or it might be caused by natural changes in the cervical cells. During a colposcopy, the doctor can determine if the cell changes are minor or if the tissues are abnormal enough to require a biopsy. A colposcopy might also be used to examine sores or warts on the vagina or cervix.

For a colposcopy, a woman is in the same position as during a routine pelvic exam: she is reclined on the examination table with her feet in stirrups. The doctor inserts a speculum into the vagina to open the vaginal canal, then applies a solution of acetic acid to the cervix. Acetic acid causes abnormal cells to turn white. The doctor might also use an iodine-based solution to highlight abnormal tissue.

If the doctor does identify abnormal cells, he or she will remove small samples of the tissue. Most colposcopy biopsies do not require anesthesia, but some doctors might choose to use it if many samples must be taken. The woman typically feels some pinching or cramping during the procedure.

After a colposcopy biopsy, it might take several weeks for the doctor to report the results. Depending upon the findings of the biopsy, the doctor might recommend more frequent Pap tests to track cervical cell changes, additional testing or treatment. In some cases, the doctor might want to remove the abnormal parts of the cervix in order to prevent further problems. The doctor might recommend a more extensive biopsy if the colposcopy biopsy does not indicate why a Pap test result was abnormal.

There are minimal risks from a colposcopy biopsy. Sometimes a woman might experience bleeding immediately afterward. There also is the possibility of cramping, discharge and bleeding for several days following the procedure. In rare cases, biopsy sites might become infected and require treatment. If a woman experiences very heavy bleeding or bleeding that lasts several weeks, she should contact her doctor.

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I did indeed try to seek counseling beforehand, but you get one chance to talk to someone and that's it. These people are available, overall, for breast operations only.

Yes, I do have a terrible fear of operations of any sort, knowing that with a weakened immune system, I can take forever to heal from even a small cut. The wound from the breast cancer operation is just now starting to get rid of the "bright red" color after 4.5 years, which is good, because every day it felt like a fresh razor blade cut.

I can't blame the surgeon because I have a weird type of skin. It's so bad that if I wear a bandaid for 24 hours on some parts of my body, the skin will peel off. Even the wounds from a 24-hour Holter monitor took about eight days to disappear. (Could be due to the spraying of agents orange, white and purple for several years?)

I finally forced myself to go for the colposcopy and it was brutal! Worse yet, I forgot the painkillers and was hugely disappointed that hospital stores didn't sell it because I wanted to take much more than they offered.

They were excellent though, and gave me two 400mg Ibuprofen and waited about an hour for it to take effect. Finally I was so dizzy I could hardly walk (not used to drugs) but still the pain was excruciating, especially for a person with a giant pituitary tumour who hasn't had sex in nearly two decades (tumour kills all desire as well as ability).

The wound was at the very top of the uterus, so I thought the pain would be brutal, but surprisingly the biopsy didn't hurt nearly as much as getting the instrument in! It felt like it was eight inches in diameter! I gave birth to a baby over 9 pounds many years ago, and the skin tore badly in the process, and I can't remember it being nearly that painful!

As it was, I couldn't endure the pain of a regular speculum, even the smaller one most doctors have on hand, so I had to go to a gynecologist for pap tests. Hers was smaller yet, so it didn't hurt.

It took about nine minutes to just get the thing in, and then one minute to do the biopsy, which wasn't painful compared to the camera. It felt like all the skin inside was stretching and tearing apart as it went in! (Probably was.)

Once I tried a teenage tampon to see how much I was bleeding overall -- seemed like only a washed out drop every day so it wasn't easy to find out otherwise. The minute I got it in it created so much pain that it had to be taken out. No matter how hard I tried, I couldn't get it out because it was hurting so much! I had to lie in a tub to soak it and attempt again. Finally after tugging as hard as I could, it came out but with a few pieces of skin. Ouch!

I don't think an older woman's thin unlubricated skin is designed for hard things like that camera. Yes, they used more and more gel, but it wasn't much better than water.

Regarding the fear of the colostomy bag as well as a hysterectomy, I feared that because I had been bleeding from the bowel every day for about seven years as well as from the front for a couple of years. (Was never constipated so don't know why.) They did find inflammation from a sigmoidoscopy but didn't know what caused it. Although I was unconscious for the colonoscopy, the report said they couldn't finish it because of patient discomfort. Because of that, there was nothing they could do but prescribe a few-times-a-day numbing compound for seven years.

A female gynecologist did the test, thank God, because my pain probably would've scared a male half to death. It felt like that camera was 12 inches across. The pain was indescribable!

I wish they would make the cover of that instrument soft and rounded like a dildo. Seriously! They likely wouldn't need that for the cute young girls (unfortunately for male gynecologists), but for older women, it would've been better to vibrate it in that push and shove it in with what felt like was the force of a tractor! No, they don't have to fear orgasm for people like me because it would've been impossible with a large pituitary tumour as well as spinal damage. The skin still burns a lot when I go to the bathroom.

They said next time (gasp!) I will have to take a stronger drug and get a ride. I was angry that I forgot the teva-ketorolac (10mg) because that drug numbs the pain of even a toe operation. Why can't they sell "that" pill to patients?

Regarding the markers, I'm still against them and still believe women should have a choice about accepting or rejecting them, and no doctor should ever be allowed to put them inside any woman without getting her signature first.

Just in case this scares other women a lot, I have to say that the "first" colposcopy probably wouldn't have been that painful for sexually active women. Subsequent ones could be a different story, because they may have to remove more.


@anon300856: The reason doctors can't use old tissue samples for biopsy purposes is because they need a current picture of what's going on with your body. Using a sample that's four years old tells them nothing. They have to know what's going on now so they can treat you appropriately.

I've never heard of anyone having a colostomy bag after having a hysterectomy. And yes, there are less invasive hysterectomy procedures, where the uterus is removed through the vagina.

As I understand it, the only time any markers are left behind, as for breast biopsies is so a surgeon can see exactly where he took the tissue, and can check the margins. It's like marking swelling on a limb with a pen so the doctor can tell if it's progressing. The marker serves as a placeholder, so to speak, so the surgeon can see exactly where tissue was removed. I can't imagine them leaving a marker after this procedure, but ask beforehand, certainly.

If you're not happy with your surgeon, get a second, third or even fourth opinion. Keep asking until you get the answers you're looking for. If your doctor won't answer your questions, find one who will. That's your right as a patient. You might also consider counseling for this fear that seems to be taking over -- not to tell you that your fears are groundless, but to help you cope with them in a healthy way. Good luck.


Oh yes, and I would like to ask a question once again also. Are any markers or other devices ever put into, or left inside women's bodies during colposcopies? I don't want such things and believe I should have a right to know.


One thing about biopsies is that by the time a patient finally goes for an operation, is that there has been so much prop damage to the tissues already that some patients are left suffering from PTS even before the operation.

This has always upset me to no end. Why can't doctors use the same tissue they took out the first time to assess cancer, instead of torturing patients time and again, before they finally get an operation? I fear such repeated assaults on the body may actually "cause" cancer down the road, even if removing them temporarily now, especially when a woman's body reacts so violently that large chunks of tissue are literally vomited out by the cervix.

Surely they will tell me these procedures are safe, as I was also told that the most toxic poisons on earth would be safe to put into my mouth or water (mercury and fluoride) but this still makes me terribly nervous.

I'm quite sure that mine isn't an innocent case also, with high grade abnormalities and bleeding, as well as previous cancer and likely also Lyme disease which will never be admitted by my province. This means that the best I can expect is that I will be sliced from side to side and possibly also have to carry around a colostomy bag, and it's that I worry about most, because dealing with wounds isn't something my body has ever done well, especially at my age.

So of course this makes me ask if all of this is worth going through. Is there such a thing as a non-invasive hysterectomy and/or colostomy, and must all people who have both, be left with colostomy bags? Seriously though, I honestly find this picture hard to accept. Those types of operations, it seems,might be best left for women who have people at home to assist them.


One thing that particularly upsets me is the amount of brutality to their parts that they have to go through before a cancer operation (Referring to breast cancer here, especially a segmental mastectony).

By the time the patient finally gets the operation, she has been traumatized so many times before the procedure that she is in shock already, just being wheeled into the operating room, feeling that because of all the numerous attacks on her body parts beforehand. If she didn't have much cancer before, she certainly will get it now.

This is what I fear most about a colposcopy: the number of brutal rippings, tearings, clippings, etc. before a woman even gets there. My breast cancer operation was four years ago and I will never forget the horror of all of the procedures which makes me now very terrified of this, too.


Are markers or other devices ever put into, or left inside a woman's body during a colposcopy? I was horrified to find out that this is often done when women undergo breast biopsies, and they are not told about it beforehand and require no permission, which I think should be regarded as a criminal act.

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    • Tissue from a woman's cervix is removed in a colposcopy biopsy.
      Tissue from a woman's cervix is removed in a colposcopy biopsy.
    • A woman with an abnormal pap smear may need to get a colposcopy biopsy.
      A woman with an abnormal pap smear may need to get a colposcopy biopsy.