The role of colposcopy in the evaluation of abnormal vaginal vault smears

Colposcopy was used to evaluate 101 patients with abnormal vaginal vault smears. Forty-five patients were seen because of atypical smears, 53 because of suspicious cytology, and the remaining three because of malignant-type cells present. The colposcopic features of the lesions seen enabled a prediction within one histological degree of the underlying pathology in 97 patients (96%). One patient was diagnosed as having invasive carcinoma, 41 patients had carcinoma in situ, and a further 23 patients were found to have severe dysplasia. Further tissue examination in the 23 patients treated by vaginectomy failed to reveal any unsuspected invasive carcinoma. The results obtained indicate that colposcopy and directed biopsy are useful, accurate methods for the evaluation of patients with abnormal cytology following hysterectomy.