DiscoverProcedure Ready: Ob/GynBefore Your First: Colposcopy and LEEP
Before Your First: Colposcopy and LEEP

Before Your First: Colposcopy and LEEP

Update: 2018-02-13
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Description

Why: ASCCP guidelines (there is an app! Or PDF)


Cervical dysplasia — caused by HPV


CIN I–CIN3 is a progression


Risk factors: Smoking, other STIs including HIV, immunodeficiency


 


Histology: Increased Nuclear: cytoplasmic ratio when abnormal


Acetic Acid: exact mechanism unknown, the higher N:C ratio cells (aka abnormal cells) reflect more light and appear white.


Lugols: Iodine rich-reacts with glycogen in normal squamous cells so they appear dark.  Non-staining cells are abnormal.


 


HPV — changes


Colpo:


Increased vascularity, punctations, mosaicism, surface contour changes


 


LEEP:


Stain abnormality and know where abnormal biopsy was taken


Single pass is ideal–tag a side for orientation


+/- Top Hat depending on ECC result


 


CKC:


Higher up in cervical canal, but more complications


No electricity– okay if pregnant


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Before Your First: Colposcopy and LEEP

Before Your First: Colposcopy and LEEP

Jennifer Doorey, MD, MS