<unk>  Transformation zone types:Type 1: Completely ectocervical (common under hormonal influence).Type 2: Endocervical<unk> nent but fully visible (common before puberty).Type 3: Endocervical<unk> nent, not fully visible (common after menopause). During the initial evaluation, a medical history is obtained. The procedure is fully described to the patient. In some cases a pregnancy test may be performed before the procedure and the patient then signs a consent form.<unk>  is performed with the woman lying back, legs in stirrups, and buttocks at the lower edge of the table (a position known as the dorsal lithotomy position). A speculum is placed in the vagina after the vulva is examined for any suspicious lesions. A<unk>  is used to identify visible clues suggestive of abnormal tissue. It functions as a lighted binocular or monocular microscope to magnify the view of the cervix, vagina, and vulvar surface. Low magnification (2× to 6×) may be used to obtain a general impression of the surface architecture. 8× to 25× magnification are utilized to evaluate the vagina and cervix. High magnification together with green filter is often used to identify certain vascular patterns that may indicate the presence of more advanced pre-cancerous or cancerous lesions. The squamocolumnar junction, or "transformation zone", is a critical area on the cervix where many precancerous and cancerous lesions most often arise. The ability to see the transformation zone and the entire extent of any lesion visualized determines whether an adequate<unk> c examination is attainable. Acetic acid solution is applied to the surface of the cervix using cotton swabs to improve visualization of abnormal areas.. Areas of the cervix that turn white (acetowhiteness) after the application of acetic acid or have an abnormal vascular pattern are often considered for biopsy. If no lesions are visible, an iodine solution may be applied to the cervix to help highlight areas of abnormality. After a complete examination, the<unk> st determines the areas with the highest degree of visible abnormality and may obtain biopsies from these areas using a long biopsy instrument, such as a punch forceps, SpiraBrush CX or SoftBiopsy. Most doctors and patients consider anesthesia unnecessary; however, some<unk> sts now recommend and use a topical anesthetic such as lidocaine or a cervical block to decrease patient discomfort, particularly if many biopsy samples are taken. Following any biopsies, an endocervical curettage (ECC) is often done. The ECC utilizes a long straight curette, a Soft-ECC curette employing fabric to simultaneously collect tissue, or a cytobrush (like a small pipe-cleaner) to scrape the inside of the cervical canal. The ECC should never be done on a patient who is pregnant. Monsel's solution is applied with large cotton swabs to the surface of the cervix to control bleeding. This solution looks like mustard and turns black when exposed to blood. After the procedure this material will be expelled naturally: Patients can expect to have a thin coffee-ground like discharge for up to several days after the procedure. Alternatively, some physicians achieve hemostasis with silver nitrate.
Colposcopy
Frozen section procedure
Cervical conization
Polypectomy
Endometrial biopsy
Breast self-examination
Pap test
Estrogen receptor test