I was trained by Ray Kauffman, at Baylor College of Medicine, in the late 1970s. He was widely acknowledged as one of the best colposcopists in the world. The subtle changes in cellular appearance after exposure to 3% acetic acid were varied and often easily missed. We were drilled repeatedly to recognize the areas most appropriate to biopsy. Recently, I had a 40 year old patient referred to me for pelvic pain, but in the course of a concomitant annual exam, performed a Pap smear. The result was HGSIL, HR HPV detected. She was instructed to come in for a colposcopy. In recent years we have replaced our traditional binocular mechanical colposcopy with a computerized DYSIS monocular. In this instance, I detected only minimum WE at 0100 and 0500, but once the DYSIS displayed the mapping, a bright yellow irregular patch could be seen from 0400-0600. Biopsies were performed at both the 0100 area and the 0500 area. I had thought from my visual colposcopy that the Pap had surely been over-read! The 0100 biopsy did indeed show moderate to severe dysplasia, but the 0500 bx, lit up brightly by the DYSIS, revealed CIS with endocervical gland involvement. A subsequent LEEP with negative internal and external margins proved curative. While I was lucky to have seen the subtle changes in the affected areas, a less experienced physician might well have missed them. But with DYSIS, the area was impossible to miss!! Every day my partners and I have more and more reason to feel justified in the decision to incorporate DYSIS into our every day practice!
Physicians incorporate DYSIS Colposcopy into their practice not only for the adjunctive cervical mapping, but also for the additional benefits of smart colposcopy technology, such as exam standardization, integration of exam images into the patient’s chart and the opportunity to involve the patient in her care.
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"After using the DYSIS Advanced Cervical Imaging System and seeing the clinical results, I don't ever want to do colposcopy without DYSIS again. DYSISmap, the documentation images and tools for tracking, add real clinical value for me and my patients. DYSIS represents a technological advancement in the identification and management of cervical dysplasia and cancer prevention."
"My associate and I have been using DYSIS for colposcopic evaluation and we are pleased and grateful for a technologic advancement that will improve our ability to provide the best care for our patients with abnormal pap smears. The DYSIS Colposcope not only provides images and tools such as color mapping, but also assists in detection of dysplasia often unseen by the naked eye. Our practice has had two cases where suspicious areas (later confirmed by biopsy as a CIS and a CIN3) were highlighted by DYSISmap, but were not seen with magnification alone!"
"This technology has the potential to revolutionize the colposcopy procedure and improve detection of cervical dysplasia, prevent unnecessary procedures and give both patients and providers confidence in the care that is provided. Our practice has found a number of advantages using DYSIS. Being able to have high resolution images to evaluate with other providers has been helpful. Also, the images can be a permanent part of the patients' records and referenced in follow up exams. We have also found many patients enjoy seeing the exam images and it can be a helpful teaching tool to both reassure and empower our patients. In some cases the mapping option has helped to identify sites needing biopsy and in others, has highlighted very small areas that could have been potentially overlooked. Our practice always stays at the front of cutting edge medical changes and technology."
"My partners and I have been extremely happy with the DYSIS system. After using DYSIS for a month, we have identified several high grade lesions with the assistance of the DYSISmap. The patients have appreciated being able to see and be involved in the colposcopic exam and understand better their condition because of the color mapping. They say it is like getting a second opinion on their abnormal Paps and colposcopy. I highly recommend this innovation and feel it is the future of evaluation and treatment of abnormal Pap smears."
"There are a number of benefits to using the DYSIS technology. It has been a good educational tool as patients are able to see images and better understand the colposcopy procedure itself. Being able to take high resolution images and keep them as part of a patient record for later review or consultation with another provider in office also improves patient care. I find the images on the monitor are better quality than the view from a colposcope; certainly viewing is easier on the eyes. In addition, being able to have the DYSISmap to help draw attention to other areas that did not stand out during the visual inspection has been beneficial. Even confirmation of areas of concern gives providers more confidence with performing colposcopies."
"I was skeptical at first – can a computer generated image really help me to pick up cervical abnormalities better than the naked eye? But I was wrong. The cervical image appeared normal to me – the DYSISmap highlighted two areas of high aceto-whitening that I investigated further, revealing cervical dysplasia on biopsy. Wow - With the new recommendations to decrease PAP smear frequency, it is even more important that colposcopies miss nothing. I’m a believer."
"The DYSIS Colposcope helps us to target biopsy areas that we might not otherwise have been suspicious about. There's also a real emphasis now on avoiding any unnecessary treatment - for a lot of dysplasia we have learned that we can safely follow those without necessarily having to treat, but to do that we have to be very certain that we can detect even subtle changes over time. Rather than trusting our memory of what an exam looked like six months earlier, the DYSIS Colposcope allows us to record and replay the exact colposcopy findings from six months earlier and therefore detect those subtle change."
"Whilst cervical evaluation with DYSIS is not a substitute for colposcopist experience and developed evaluation skills, its digital analysis has become my "instant, reliable, second opinion". DYSIS allows me to be a more consistent colposcopist thereby maximising reproducibility of results among clinicians. It allows me to educate, explain and reassure my patients. Lastly, it is a great teaching tool - for residents, patients, mid-level providers and my staff."
"A long-term patient returned for her annual exam after an absence of ten years. Her Pap Smear was read as negative cytology, +mRNA, +type 16 HPV. She had a normal Pap history prior to this exam. She returned for a DYSIS screening colposcopy and has a normal exam except for a white area on DYSISmap at 6 o'clock. Biopsy on that site was + adenocarcinoma. She underwent a robotic hysterectomy with no invasion seen. I was sold on DYSIS thereafter."
"I had a patient who had a LGSIL, HPV+, PAP, who had a colpo done which was negative. Patient had AUB (Abnormal Uterine Bleeding) for 6 months and wanted a hysterectomy. Patient had a D&C (Dilatation and Cutterage) HIS (histoscope) which showed a few cells of HGSIL. Patient then had a DYSIS colpo which showed HGSIL confirmed with biopsy. Patient had a LEEP which confirmed HGSIL. A case which may have affected her treatment options severely."
"I have been very pleased with the cervical images. In the short period of time I have had it, it has already helped me to pick up several high grade lesions. I had one patient with ASCUS on Pap, and I expected to find koilocytosis or CIN1 on biopsy, but because of DYSIS I biopsied a site that was CIN2/3 and have now scheduled this patient for a LEEP."
"Outside of the obvious benefits of the DYSISmap the system helps make the patients an integral part of the process. It allows me to explain to the patient exactly what is occurring during their colposcopy. Many patients find this helpful to calm their nerves and that it gives them a better understanding of the procedure."
"The DYSIS colposcope has made cervical dysplasia and colposcopy a more interactive tool for patient education. It has decreased patient anxiety through the procedure and affords a more in depth understanding of the HPV effect on cervical cells. In addition, I believe it helps reduce subjective discrepancies between exams and accurately targets high grade lesions."
"DYSIS has impacted my practice in 3 key ways: Before DYSIS, it was a challenge to tell patients what we saw during their colposcopy, but now the patients can actually be involved with the exam. Also, having the images stored for follow-up is very helpful when reviewing patients' history. The most compelling impact on my practice has been having the DYSISmap in combination with my own eye and over 23 years of experience!"
"I believe the DYSIS Colposcope gives me the ability to see exactly where the abnormalities of the cervix are located. The DYSIS colposcope helps to prevent me from having to perform "random" biopsies which I have found causes my patients unnecessary pain, but in the past, were recommended and helped me feel certain that I did not miss any cervical dysplasia. This system is unique because it measures very accurately the aceto-whitening effect and it helps to ensure that my biopsies are done precisely where they should be done. In addition, the monitor allows patients to be a part of the procedure and to have a complete understanding of how their cervix looks before and after the acetic acid - and the significance of that change. This creates a unique opportunity for me to not only accurately see dysplasia, take precise biopsies, but also to have the patient actively participate in the entire process. The moment I knew this system existed, I knew right away that this was such superior way to diagnose and treat cervical dysplasia."
"The DYSIS Colposcope has given me much more confidence in my colposcopies. I feel like I have a second pair of eyes watching over me. In fact, I do!"
"I'm impressed by the DYSIS Colposcope. It's ability to help me to select biopsy sites has resulted in me finding an increased number of significant pathologies."
"The instant feedback with the DYSISmap really gives me the reassurance and confidence when deciding from where to obtain my biopsies. The visualisation of the map by the patient also enhances their understanding of the process."
"The optics on DYSIS really make a difference. The only accommodation I had to make was with a small change to my biopsy technique. Overall I am very pleased to use the system."
"I have recently started to use the DYSIS Colposcope and it has only added to my medical practice. The clear images and DYSISmap have been instrumental in teaching patients. Also, I have identified additional lesions with the help of the DYSISmap technology, which has led to changes in management and better patient care."
"The DYSIS Colposcope has been a welcome addition to our practice. The clarity of images is outstanding. Patients appreciate the latest advances in technology as well as the option to visualise their pathology. The ease of use and DYSISmap feature exceeds conventional colposcopy."
"DYSIS provides excellent visualisation with exacting confirmation of optimal biopsy sites. It provides the opportunity for patient participation with superb charting of pictorial documentation. All of the above combine to establish DYSIS as the next generation of colposcopy."
"DYSIS is amazing! Colpos are now faster and more accurate. The images are so much clearer than with traditional colposcopes. The patients love seeing the abnormal areas; they feel more educated about what is going on with their bodies."
"The addition of DYSIS assisted mapping to my routine colposcopy has increased our pick up of lesions and confidence in our results. The picture documentation is invaluable for recall when pathology reports become available. The best part is the ability to include and educate patients so that they become partners in their care."
"We have had our DYSIS for five months, and it's great! We had one 32 year old patient with HrHPV+, Pap negative. ASCCP Guidelines are to repeat in a year, but we decided to colpo. Straight forward visualisation and the colpo didn't show any abnormalities, but the DYSISmap revealed a large area of interest that returned a biopsy result of CIN3! DYSIS is great! And patients become more involved in their care when they can actually see the abnormal area!"
"I have been practicing OBGY for approximately 40 years both in the Military and private practice as well as teaching Residents. I started out in the mid 1970's with 4 quadrant biopsies and cold knife conization. Watching classification from class 1 through 4, to CIN1 to Dysplasia. Then came colposcopy and aceto-white lesion, abnormal vessels and gross lesions as you have also experienced. Using the DYSIS instrument both in private and clinical practice with the associated mapping capabilities has revolutionized the accuracy of these diagnoses. It has also been a valuable teaching and follow-up device. We can go back and review our impression and accuracy which has been amazing. I have no stocks or sanction invested in DYSIS. I have received no compensation nor expect to."
"What I love most about DYSIS is how interactive it can be for the patient. Being able to visualise the cervix and its mapping - my patients have a better understanding of the need for evaluation. The precision of the DYSIS technology not only gives me more confidence in the biopsies taken, but it also increase my patients reassurance."
"The DYSIS colposcopy has made a tremendous impact on my practice by allowing patients to be able to see and understand cervical dysplasia and it has also been a useful tool in teaching our residents and medical students. It also gives us more objective information during colposcopy which has traditionally been very subjective: proven by the fact that random biopsies are just as good as traditional colposcopically directed biopsies! Hopefully with this new technology our ability to detect dysplasia will continue to improve."
"There is no doubt that we are more accurate with the DYSIS Colposcope. There has definitely been times that the DYSISmap has helped me to pick up areas of dysplasia that I would not have otherwise biopsied. With the DYSIS Colposcope, not only has our detection rate increased, but the level of education and understanding for our patients has significantly improved."
"The DYSIS has made colposcopy a teaching tool where patients can better understand colposcopy and cervical dysplasia. It provides a second opinion on targeting biopsy sites. Being able to integrate colposcopy images into the patient's chart helps with monitoring lesions and better targeting of lesions that require further treatment."
"I have introduced the DYSIS advanced cervical imaging system into my practice for colposcopy and biopsy. The difference it makes in detecting specific areas of dysplasia on the cervix is second to none. It has significantly improved identification of biopsy sites where the burden of disease is highest. This should definitely become the standard of care for women with abnormal cervical Pap" Smear.
"DYSIS Colposcopy has changed the management of cervical dysplasia within my practice. The enhanced imaging and archive have allowed my patients to have the confidence of leading technology coupled with years of physician experience."
"I like the reassurance of true negative results, which prevents the need to perform random biopsies. This gives my patients more comfort during the exam. The added information the DYSISmap provides on each patients' evaluation also allows me to better assess my finding. I highly recommend having DYSIS for your practice and your patients."
"DYSIS is an incredible addition to women's healthcare. I have already identified areas of concern with the DYSIS mapping, which would have been overlooked with the naked eye. The standardization of the entire process gives me reassurance that there is enough acetic acid applied and enough time passed during the exam to get the best results. My patients are also much more at ease seeing what I see in real time."
The DYSIS Colposcope has already helped me take better care of my patients in the short time that I have been using it. DYSIS not only gives me more accurate cervical imaging, it helps my patients better understand what is going on with their own cervix. I explain to each patient that the DYSISmap is like "Doppler radar" for the cervix and that it helps me to pinpoint areas that need a biopsy or it gives me confidence that they may not need a biopsy that day. It is wonderful to have something that is new and improved in our on-going battle with HPV and cervical cancer.
Since introducing DYSIS to my practice, I am able to identify smaller lesions with greater accuracy. The high resolution images have allowed for better charting, patient care, and follow-up. The DYSIS Colposcope has been a valuable addition to our office.Since introducing DYSIS to my practice, I am able to identify smaller lesions with greater accuracy. The high resolution images have allowed for better charting, patient care, and follow-up. The DYSIS Colposcope has been a valuable addition to our office.
Dr. Fellenbaum tells us how the DYSIS Colposcope has helped to offer his patient's the best care possible.
"Women’s Care Florida adopted a DYSIS Colposcope to improve their standard of care. Dr Kapitz tells us how it has improved cervical detection of patients."
"I had been interested in DYSIS for several years but had never had the opportunity to pursue it further. Due to our existing equipment coming to the end of its lifespan we were able to engage with the team at DYSIS and truly understand the benefits it had to offer. The process of completing the relevant business cases and getting appropriate sign off, at times, felt never ending but the support and guidance from the DYSIS team was greatly appreciated. We have now been using DYSIS for 6 months and the time spent acquiring it was most certainly worth it. The DYSIS has not only offered us adjunctive mapping, it has also enabled us to store patient images and playback the examination for MDT use. This technology has helped improve the quality of the teaching we can offer to the learners involved in the service. The patients have also greatly benefited from this. I have found the DYSIS to be intuitive to use and is ergonomically sound minimising musculoskeletal issues for the operator."
"Cervical Screening Wales is currently running a service evaluation of the DYSIS colposcopes in 4 of its colposcopy clinics. First impressions are that the quality of the imaging is superb and colposcopists have been surprised that some low grade appearing abnormalities yield high grade CIN after taking biopsies when assisted by the DYSISmap."
"As a Nurse Colposcopist, initially I felt apprehensive about using the DYSIS Colposcope; however I have quickly learned to operate it and find the unit very easy and comfortable to use. The DYSISmap feature enables patients to clearly visualize their cervix; which provides an additional tool when explaining the outcome of the colposcopy examination. I would say that DYSIS can benefit all Colposcopists, whether they are of a medical or a nursing background to improve their sensitivity and can aid patient management decisions."
"As a leading gynaecological oncology centre, the Northern Gynaecological Oncology Centre in Gateshead was an early adopter of DYSIS. We use DYSIS to help us to improve sensitivity and also to optimise the management pathway for specific patient groups including mis-match cases that are recognised as a challenge in colposcopy. Our research performed by Dr. Christina Founta on post-treatment (test of cure) patients shows DYSIS is very helpful in the detection of residual/recurrent CIN. DYSIS is the colposcope of choice in our department in helping us to improve outcomes and provide greater reassurance for both patients and colposcopists."
"As an experienced specialist, one is always keen to embrace new technologies and advancements in clinical practice. DYSIS is one such new technology in colposcopic practice that helps with diagnosis, thus improving targeted treatment and ultimately improved patient outcomes."
"As a leading gynaecological oncology centre, the Northern Gynaecological Oncology Centre in Gateshead was an early adopter of DYSIS. We incorporate DYSISmap for its accurate analysis of the aceto-whitening and also to optimise the management pathway for specific patient groups including mis-match cases that are recognised as a challenge in colposcopy. Our research performed by Dr. Christina Founta on post-treatment (test of cure) patients shows the DYSIS Colposcope significantly helps us to detect residual/recurrent CIN. DYSIS is the colposcope of choice in our department helping us to improve outcomes and provide greater reassurance for both patients and colposcopists."
"DYSIS is a very exciting and much needed high-tech imaging system that will improve the detection of Cervical dysplasia in comparison to conventional colposcopy. The future looks bright for DYSIS in terms of effectiveness and cost. Since starting DYSIS at my unit I feel confident it will live up to its expectations."
"We have recently started using DYSIS in our clinic at Kings PRUH and I have found the system very user friendly and easy to use. I have found it allows increased confidence in discharging women to 3 yearly recall after a low grade smear and positive HPV."
"I have found using the DYSIS Colposcope to be invaluable for those complex low grade cases and the subsequent follow-up management. The DYSIS images and examination playback are instrumental during MDT meetings."
"I find DYSIS to be valuable for the colposcopy examination. It helps me to increase my sensitivity in the identification of abnormal areas and therefore to reduce the number of biopsies taken. I also find it useful in educational settings for patients, student nurses and medical staff alike. I provides such clear visual evidence when explaining findings and the procedure."
"We've been using DYSIS for several years now and it is a very valuable piece of equipment for our unit. I find that the DYSISmap provides me with reassurance when deciding to take biopsies and form what location. It has also helped me to pick up many high grade lesions when cytology suggested Low Grade abnormalities."
"Having a colposcopy is a very anxious time for women especially our younger patients - in my experience many of the women who come for colposcopy are visiting hospital for the first time. Due to the increased accuracy DYSIS provides, we can confidently discharge women to routine follow up with added reassurance, knowing there is nothing that we may have missed."
"In clinical practice, DYSIS is a great tool for the management of cervical lesions. In my experience, DYSIS helps me to identify and grade the cervical lesions visualized in colposcopy, also improving the diagnostic accuracy. Besides that, it also helps me to choose the best place to take biopsies. Combining the DYSISmap into my colposcopy has helped me to increase the detection rate of CIN2+ by almost 20% in our center."