What is colposcopy?

by Dr. med. Stefan Seidl, FIAC – Hamburg

Colposcopy first emerged as a science in the 1920s, when cervical cancer with visible symptoms became more prevalent among young women. It was then that the German physician Hans Hinselmann found an optical magnification system to facilitate the detection of small carcinomatous neoplasms.

In the beginning, he used a Leitz dissection magnifier. He called his technique "colposcopy", derived from the Ancient Greek words "kolpos" (meaning vagina), and "skopos" (meaning to look at). The suffix "-scopy" may refer to the organ under examination, e.g. vulvoscopy, mamilloscopy, or dermatoscopy.

Colposcopy is an optical micro-inspection procedure to obtain an enlarged image (4x to 40x magnification) of the tissues under examination. Colposcopy is one of the routine diagnostic procedures performed by practical gynaecologists. Indications for a patient to undergo colposcopy include early detection of cancer, early detection of inflammatory and functional pathologies, and postopertive and follow-up controls.
Its stereoscopic visualization capacities make the coloscope also a useful tool for dermatologists in diagnosing skin pathologies.

Hinselmann's vision to contribute to the early detection of cervical cancer through colspocopy has since come true and meanwhile exceeded his expectations. For decades, colposcopy has been established worldwide and considerably contributed to understanding the formation of cervical cancer. 

Since it was revealed that cervical cancer is related to human papillomavirus, the advantages of colposcopy have become obvious. Colposcopic differential diagnosis, performed during dysplasia consultation, by an independent gynaecologist or in the women's health division of a hospital, allows for the detection and differentiation of the various forms of HPV-related infections, ensuring specific treatment is given.

Colposcopes are often used as a microscope in surgical laser and LEEP procedures.
Tele-colposcopy can be regarded as the latest development, allowing for a live video feed of the examination that can be transmitted worldwide via the internet. Tele-colposcopy enables an expert gynaecologist to monitor the procedure, and facilitates computer-assisted training and education.