TEN COMMANDS TO BE A COLPOSCOPIST

Posted by e-Medical PPT Thursday, March 22, 2012
Colposcope
Stereoscopic, Binocular
 Microscope with 3 specifications:
low magnification (10 – 40) *
Focal length (20 – 25 CM)
Width of visual field > 25 MM.
- NB: Colpomicroscope (150 – 200)

Gynecologist should be aware of:
  1. Value
  2. Instruments.
  3. Different terminology (Anatomical – histological Pathological – Cytological and Colposcopic)
  4. Indications.
  5. Steps for colposcopy
  6. Diagnostic Criteria.     
  7. Interpretation.
  8. Pitfalls.                         
  9. Training.
  10. Treatment.

Value of Colposcopy
Fill the gap bet. N/E & Cytopathology.
2. Early detection for precancerous lesions of lower genital tract (CIN, VAIN, VIN).
3. Decrease diagnostic conization and hysterectomy.
4. Complementary for cytology or VIA  (Each one cover the disadvantages of the other).
CYTOLOGY DISCOVERS THE CRIME &COLPOSCOPY LOCATES THE CULPRIT.

1.Colposcope:
Optical system ( 7.5 – 40 ).
Illumination system ( Dim or Bright ).
Stand (Easy movement).
Accessories ( Gray  filter – Camera +Electronic flash ).

2.Auxillary:
Set for cytology.
Set for Biopsy.
Speculae ( non polished or plastic ) & Kogan’s.
Chemicals( Lugol’s Iodine - Acetic acid 3% - Monsol’s  sol .saline)
Cotton Buds-singley’s forceps – iris hook

3.extra –auxillary:

Pathological terminology
Metalplasia.
Dysplasia (BET SQU. Epith & CIS.) – (Dediff. + disarrangement).
CIN (I, II, III).
Micro invasive (< 5mm + no vascualr and lymphatic extension).
Invasive carcinoma:
Hyper keratoses : (= leukoplakia)
Parakeratosis.

Indications for Colposcopy
Diagnostic:
 Abnormal pap, smear….VIAM
 Any suspicious lesion (CX – Vagina – vulva).
 In – utero exposure to diethyl stilbestrol (or) related drugs.
 Infertility (?) [cervical factor].
 Sexual assault victims.

Therapeutic:
 Cryocautery.
 Diathermy (loop).
 Laser
.

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