Colposcopy of the vagina and vulva

Colposcopic evaluation of the vagina and vulva is an important adjunct to cervical colposcopy because human papillomavirus disease can be multifocal and multicentric. Other reasons for vulvar and vaginal colposcopy include cytology unexplained by cervical findings, vaginal and vulvar symptoms, and diethylstilbestrol exposure. Vaginal and vulvar intraepithelial neoplastic lesions are important cancer precursors to evaluate and treat. Many lesion types have a similar appearance, and biopsies should be used to elucidate the cause of the colposcopic findings.