A loop electrosurgical excision procedure or LEEP is a procedure to remove precancerous cervical cells from the cervix. Cervical dysplasia is another term we use for abnormal cells on the cervix. A LEEP is one way we can treat cervical dysplasia by removing the cells and allowing new and healthy cells to grow.
There are other treatment options for dysplasia including cryosurgery, electrocautery, laser and cone biopsy. Treatments are typically reserved for cases of moderate or severe dysplasia. Dysplasia is diagnosed using a colposcopy procedure.
The LEEP Procedure
During a LEEP, a heated electric current is passed through a thin wire. This wire “loop” is then used to remove a small portion of the cervix containing the abnormal cells. In our practice, LEEPs are performed in the office setting. The procedure should not be done at the time of your period. This allows for a better view of you cervix. The procedure only takes a few minutes.
During the procedure you will lie on your back and place your legs in stirrups. The doctor will insert a speculum into you vagina to visualize the cervix in the same way as for a routine pelvic exam. The cervix is painted with a solution and colposcopy is used to magnify the cervix during the procedure.
Your cervix will then be numbed with local anesthesia. The anesthesia will be administered with a needle attached to a syringe. You will remain awake during the procedure and can experience a dull pain and cramps. The loop is inserted into the vagina to the cervix. The loops come in different sizes and shapes and they are selected based on the anatomy of your cervix and the area containing the abnormal cells. After the procedure a medicated paste will be applied to the cervix to help with healing. This paste may cause a dark brown discharge after the procedure. You can also expect some light bleeding after the procedure.
Recovery After The Procedure
It takes 2-3 weeks for you cervix to heal after a LEEP. It is very important to refrain from sexual intercourse and the use of tampons until your post-operative appointment. This will allow the LEEP site to heal appropriately. You can expect the following symptoms in the postoperative period:
- vaginal bleeding (less than a normal menstrual flow)
- mild cramping
- brownish black discharge (from the medicated paste used)
If you experience fever, chills, or heavy vaginal bleeding, it is important that you notify your doctor immediately.
The tissue that is removed at the time of the LEEP is examined by a pathologist in a laboratory. The tissue helps confirm the diagnosis. The final follow-up plan is made based on these results. You will be scheduled for a postoperative visit 2-3 weeks after the procedure. It is important to be seen on a regular basis for your gynecologic visits and Pap tests. After a LEEP, every patient will need repeat pap smear at least once a year.