Why should we go to cytology?
Ela Podhorská 12.12.2018
Only 25% of women undergo regular preventive examinations with a gynecologist. I believe this article could serve as inspiration for making an appointment.
Cytological examination
Cytological examination involves the microscopic analysis of cells obtained through a light smear from the surface of the endometrium. It is a standard procedure during preventive examinations by a gynecologist. This diagnostic method is reliable, time-efficient, and capable of detecting early changes in cervical cells, as well as very small tumors that may not be visible during routine examinations.
When to schedule cytology?
Schedule a cervical examination in the middle of your menstrual cycle, approximately two days after the end of your last period or around 10 days from the first day of your last period. Discontinue the use of vaginal products two days before the examination, and avoid sexual intercourse the night before.
Cytology Results
Finding cannot be evaluated: This indicates that the test could not be reliably performed on the sample. The doctor will recommend repeating the cytological examination, usually after 3 months.
Normal finding: Most women receive a normal cytology result, meaning no changes that could lead to cancer have been detected. The risk of cervical cancer is minimal. Continue screening annually.
Abnormal finding: This suggests that changed cells were identified in the cytological smear. However, these changes are usually not serious and do not necessarily indicate cancer—it is only rarely diagnosed. Nonetheless, they serve as a warning signal, and the woman should be carefully monitored in the event of an abnormal finding.
According to the results of the abnormal finding, your doctor may recommend:
- Another cervical smear in 3 to 6 months – to observe whether the abnormal cell changes have regressed, remained the same, or progressed. If subsequent check-ups show normal findings, the interval between checks can be extended to 6 months. If consistent normal results are confirmed, the woman can be monitored similarly to healthy women. Conversely, if abnormal cells persist, the doctor will recommend further examination.
- Colposcopic examination – enables a more detailed inspection of the cervix using a specialized device similar to a microscope.
- Test for the presence of the HPV virus – to identify patients with a higher risk of developing cervical cancer.
Colposcopic Examination
This is a visual inspection of the cervix using a special optical device called a colposcope. The examination allows for the observation of changes on the cervix. To enhance visibility, the cervix is coated with an acetic acid or iodine solution—healthy cells typically turn brown, while abnormal cells may appear white or yellowish.
The doctor then utilizes the colposcope, which is an instrument similar to a microscope, to observe the color of the tissue, vascular changes, the mouth of the glands, the presence of condylomas, and other characteristics. Notably, this examination is akin to a cervical smear and is non-invasive, causing minimal discomfort to the patient, as the device remains outside the woman’s body.
Biopsy
A biopsy is employed when abnormal findings have been cytologically and/or colposcopically confirmed. This procedure serves to definitively confirm or rule out cancer. Using small, specialized forceps, the doctor extracts a tissue sample measuring about 2-4 mm in size. The collected tissue is then sent for microscopic examination—a biopsy.
Tissue collection is comparable to a routine gynecological examination and typically does not necessitate anesthesia. Most women will experience only a slight pinch. Following the procedure, light bleeding may occur for 3-4 days (pads or tampons can be used), and patients are advised not to bathe for 3 days. Instead, showering is recommended, and sexual intercourse should be avoided for 3 days.
Conization
Conization is akin to a biopsy but offers a more in-depth assessment to determine if abnormal cervical cells have penetrated deeper into the tissue. Unlike a biopsy, which often only confirms surface-level changes, conization involves the removal of a larger, cone-shaped tissue sample for microscopic examination. This procedure is crucial for a comprehensive evaluation.
Conization is conducted under local anesthesia or general anesthesia and is typically performed in a hospital setting. It is not only a diagnostic tool but also used in the treatment of precancerous changes, involving the removal of the entire affected area of the cervix.
As far as prevention is concerned, it’s also about your immunity.
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“However, it remains true that regular gynecological examinations are the best preventive measure,” concludes gynecologist MUDr. Ilona Hegerová.
Prevention is fundamental and crucial—don’t forget to consider it for your teenage daughter as well.”
