how they are carried out and what they are used for
diagnostic tests for the prevention of papilloma virus
There colposcopy, vulvoscopy and HPV represent three fundamental tools in the lower genital tract assessment, used to identify changes in the cervix, vagina, and vulva, and to diagnose the possible presence of the human papillomavirus. The combination of these tests provides a comprehensive overview of the health of genital tissue, allowing for further investigation of abnormalities found on Pap tests, suspicious lesions, or symptoms related to abnormal bleeding.
The exam is divided into three complementary parts: vulvoscopy, vaginoscopy And colposcopyUsing progressively magnifying lenses, the doctor first examines the external genitalia, then the vagina, and finally the cervix. To highlight any lesions, a solution may be applied that may cause a slight, temporary burning sensation.
In case of suspicious areas, it is possible to perform a targeted biopsy, which causes little bleeding but does not require additional care. In some cases, benign lesions can be treated immediately with techniques such as LLETZ, a procedure that removes the affected areas with electrocautery.
how and when to do it
colposcopy
What is colposcopy for?
Colposcopy is a second level examination that allows us to highlight benign, pre-neoplastic or neoplastic lesions of the cervix, vagina, and vulva. The main indications include abnormalities found on Pap tests, such as ASC-US, AGC, ASC-H, L-SIL, and H-SIL, as well as the presence of cervical polyps, ectopia, condylomas, abnormal bleeding, and a positive HPV test.
Its purpose is to accurately visualize any altered areas that would not be detectable with the naked eye, thus supporting the gynecologist in the decision to perform a biopsy, schedule a follow-up or intervene with a targeted treatment. The exam is painless, non-invasive and can also be performed during pregnancy without risks to the fetus.
when to perform colposcopy
The test is performed on an outpatient basis and lasts approximately 10–15 minutes.
For optimal viewing, it is recommended to run it 10 days after the end of menstruation, when the cervical mucosa is most visible. No specific preparation is necessary, but it may be helpful to avoid sexual intercourse, tampons, suppositories, or other intravaginal devices in the 24 hours leading up to the test. It does not require anesthesia or the presence of a companion, and there are no restrictions after the test.
testing and role in prevention
hpv - human papillomavirus
The HPV test has the function of detecting the presence of the Human Papillomavirus, identifying high- or low-risk histological types. HPV infection is the main risk factor for the development of cervical cancer, particularly for high-risk histological types such as 16, 18, 31, 33, and others. Low-risk histological types (such as 6 and 11) are associated with the appearance of genital warts.
The test is usually ordered when an abnormal Pap smear is present and does not require extensive preparation. It is advisable to avoid vaginal douching, sexual intercourse, and the use of lubricants in the two days preceding the test, and not to take the sample during menstruation. The test is quick, painless, and provides a clear result regarding the presence of the virus.
How the test is performed
During the HPV test, the patient is positioned on the gynecological table. The doctor inserts a speculum into the vagina to visualize the cervix and uses a soft toothbrush (cytobrush) to collect cells for analysis. The collected sample is then sent to the laboratory, which determines whether an HPV infection is present and, if so, identifies the histological type.
A negative result indicates the absence of oncogenic infections, while a positive result does not imply the presence of cancer but represents a risk factor that requires clinical monitoring. In these cases, the gynecologist may prescribe a follow-up or suggest further tests, such as colposcopy with possible biopsy.
results
interpretation of results and follow-up
Management of HPV test results depends on the histological type found and the patient's clinical condition. A positive result may be transient, especially in younger women, and resolve spontaneously. In cases where the infection persists, it is essential to schedule regular follow-up to monitor the possible progression of cervical lesions. The goal is to identify any cellular changes early and promptly intervene with targeted treatments.
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