Colposcope

All there is to know about a colposcope

A colposcope is an instrument used to perform a colposcopy. It is a special examination of the vulva, vagina, and cervix performed by a doctor to determine any inner pathology signs. This procedure's main indication is detecting any signs of inflammatory or abnormal cells during the PAP test. This procedure gets used along with a biopsy and cytology. Usually, this examination gets performed for determining cancer diagnosis.

A colposcope looks like a big apparatus, situated on the tripod with an optical enlargement, and lightning tool on the upper part. Access to the vulva is obtained, usually by inserting a unique gynecological mirror into the vagina. Those mirrors may comprise plastic or metal. Nowadays, doctors generally use plastic disposable mirrors to prevent different types of bacterial contamination.

A little bit of history of a colposcope

The first-ever created experimental colposcope was not very satisfying from the diagnostic perspective, as it only showed the picture from the focus distance of 80 mm. The prototype was constructed in March 1924 by German inventor and gynecologist Hans Hinselmann. He tried to solve this issue by pulling out the tissues of the cervix. 

In 1951 Kara-Eneff in Hamburg showed the first-ever created photos and slides, made with the help of the electrical flash, to the scientific society. Hinselmann tried to obtain the first TV records of the procedure even earlier in 1951, but unfortunately, he failed due to technical reasons. Kara-Eneff's improvement gave a high burst into the development of these apparatuses. 

In 1971 the British colposcopy group was created. This group examined Hinselmann's notes, greatly improved the whole apparatus, and made it look almost modern. They made a few more improvements before humanity got the modern-looking colonoscopes and started to use them for regular check-ups and diagnostic procedures.

Indications to use a colposcope

A colposcope gives a clear view of the examined patient vagina, vulva, and cervix. Usually, to get a more accurate view of the cervix and to prevent the development of different bacterial complications, doctors use various types of one-off gynecology mirrors. There are many inflammatory pathologies, cancers, and other tumors among different indications of using a colposcope. Here is an example of those pathologies:

  • Tumors of the vulva
  • Vaginitis of various etiology
  • Tumors of the vagina
  • Urethritis of various etiology
  • Various pregnancy troubles
  • Tumors of the urethra
  • Cervicitis of various etiology
  • Cysts of the vagina, and vulva
  • Vulvitis of various etiology
  • And many others

The biopsy or cytology is a straight indication to use this type of instrument, as there is no possibility to achieve any access to the cervix and vulva. At the same time, there is still a way to get laboratory material from the vagina. This method is called the vaginal swab and is usually performed with the help of a speculum. The whole process goes in sterile conditions. Typically, doctors use it to determine any signs of protozoan, bacterial, and fungal diseases in the vagina. Often it helps to make a proper assessment for the treatment.

Among the other indications to use this instrument is different inborn pathologies. These pathologies usually make the whole anatomy of the patient's reproductive system ineffective to gestation. Also, in many cases, there is a big possibility that different bacterial, fungal, or protozoan infections will lead to the same result if they are untreated during an acute phase of the disease. Among inborn pathologies are:

  • Agenesis of vagina
  • The bicornuate uterus
  • Cervix uteri stenosis
  • Aplasia of vagina
  • Multiple cysts of the ovary
  • Agenesis of uterus
  • Alpasia of uterus
  • And many others

 

This instrument is also often used in case of urgent situations, like vaginal or uterine bleeding. Those processes may lead to an extremely fast occurrence of hypovolemic shock, coma, and even death. Up to 20 - 30% of women are used to experiencing uterine bleedings not connected with pregnancy. That is why they perform a colposcopy to examine those organs, oxytocin injection, make a coagulation therapy procedure, or use a tamponade.

Complications of using a colposcope

The colposcope is an extremely beneficial instrument in the obstetrics and gynecology field, but unfortunately, there are lots of different complications during the procedure that may occur. We decided to divide the whole massive possible complications that may happen during the colposcopy process into three main groups. And here is what we got:

  • Bacterial invasions
  • Mechanical trauma
  • Bleedings due to insecure manipulations

Bacterial invasion is the most common pathology in clinics where the old, metal vaginal mirrors are still used. These complications usually connect with sexually transmitted diseases and viruses, like herpes virus, human papillomavirus (HPV), and bacterial diseases caused by chlamydia. But, very often, different types of various bacterial and viral agents can determine the inflammatory processes and infectious diseases.

Another complication is mechanical trauma caused by different parts of a colposcope, mirror, and even by smear and biopsy tools. Usually, those traumas are not dangerous but may cause pain and discomfort for some time. But there are also well-known cases of a severe inflammatory process developed from scratches, wounds, and other different types of damaged mucosa membrane. Also, a perforation may occur, which potentially may end with peritonitis.

Bleeding often occurs as a result of insecure manipulations of the medical practitioner during the procedure. Bleeding also may often be a sign of perforation of vulva and vagina, but not always. Even studies show that uterine bleeding caused by intrauterine devices are mostly not very dangerous, have rare death cases, and are also known in medicine. The most hazardous type of bleeding occurs when the vaginal or uterine arteries are damaged, but that happens rarely.

General Specifications

Mostly, the construction of modern colposcopes is pretty much similar to one another. But small differences in specs still may be found. That is why we picked up ten of the most commonly appeared specifications and made a list out of them. And here is what we got:

  • Magnification of highest quality - from 1 up to 52x
  • Display - genuine tissue color and tone
  • Electronic green filter - no light loss
  • LAN & HIS integration - available as an option
  • Acetic acid test timer - in basic complect
  • Minimum illumination - 0,1 Lux
  • Statistics mode - in basic complect
  • Recommended lamp life - up to 50 000 hours
  • Aspect Ratio - 16: 9
  • Sony Sensor - 1080p resolution (1920 x 1080)

Market Leaders

Usually, most models of a colposcope are manufactured by the same companies that create other instruments for obstetrics and gynecology purposes. Those instruments include different scissors, vaginal and uterine mirrors, forceps for abortus, and much more. Among those companies, for example, are:

  • RAISTON
  • Slight Edge UG
  • MED & IT Trading
  • Tekyard LLC
  • Hospital Direct Medical
  • Origin Medical Equipment Distributors
  • State of the Art Medical

Conclusions

A colposcope is an essential instrument in obstetrics and gynecology, mostly used for various diagnostic purposes. Usually, doctors also combined this procedure with biopsy and/or cytology. There is a lot of valuable diagnostic information gathered during these procedures. A colposcope is an expensive, valuable, and essential instrument for any gynecology and obstetrics clinic.

The next generation of a colposcope will show even more significant and more accurate diagnostic results. The magnification and resolution of the whole system will probably increase, even more, helping doctors obtain even more high-quality images of the uterus, vagina, and cervix. 

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