Colposcopy is a diagnostic procedure in which a colposcope (a dissecting microscope with various magnification lenses) is used to provide an illuminated, magnified view of the cervix, vagina, and vulva.  This is often the next step in the evaluation process that follows an abnormal pap smear.  During this procedure, vinegar will be applied to the cervix, and the gynecologist will then examine the cervical tissue with the microscope.  There are certain changes the cervix undergoes once vinegar is applied that can be suggestive of HPV or other precancerous lesions.  At this point, the physician may elect to take a small biopsy from a specific area that appears abnormal.  This will help determine the proper treatment and follow up for the patient.  The results from any biopsy are usually available to the physician in about 7-10 days.  There is usually little or no  pain during this procedure.  We recommend that the patient take 600mg of Motrin 30 minutes prior to the procedure and refrain from intercourse for 48 hour prior.  We advise that the patient abstain from intercourse or anything in the vagina for 2 weeks following the procedure.  There is often a brown/mustard/ black discharge that can be present on and off for 2-3 weeks.  The patient should call the office if there is a fever greater than 100.4, intense pelvic pain not relieved by Motrin/ Tylenol, or heavy bleeding (soaking a pad in an hour or less).