LOOP ELECTROSURGICAL EXCISION PROCEDURE
What is a loop electrosurgical excision procedure (LEEP) and why is it done?
If you have an abnormal Pap test result, your health care provider may suggest that you have a loop electrosurgical excision procedure (LEEP) as part of the evaluation or for treatment (see the FAQ HYPERLINK http://www.acog.org/publications/faq/faq085.cfm The Pap Test). LEEP is one way to remove abnormal cells from the cervix by using a thin wire loop that acts like a scalpel (surgical knife). An electric current is passed through the loop, which cuts away a thin layer of the cervix.
How is LEEP performed?
A LEEP should be done when you are not having your menstrual period to give a better view of the cervix. In most cases, LEEP is done in a health care provider’s office. The procedure only takes a few minutes. During the procedure you will lie on your back and place your legs in stirrups. The health care provider then will insert a speculum into your vagina in the same way as for a pelvic exam. Local anesthesia will be used to prevent pain. It is given through a needle attached to a syringe. You may feel a slight sting, then a dull ache or cramp. The loop is inserted into the vagina to the cervix. There are different sizes and shapes of loops that can be used. You may feel faint during the procedure. If you feel faint, tell your health care provider immediately. After the procedure, a special paste may be applied to your cervix to stop any bleeding. Electrocautery also may be used to control bleeding. The tissue that is removed will be studied in a lab to confirm the diagnosis.
What are the risks of LEEP?
The most common risk in the first 3 weeks after a LEEP is heavy bleeding. If you have heavy bleeding, contact your health care provider. You may need to have more of the paste applied to the cervix to stop it. LEEP has been associated with an increased risk of future pregnancy problems. Although most women have no problems, there is a small increase in the risk of premature births and having a low birth weight baby. In rare cases, the cervix is narrowed after the procedure. This narrowing may cause problems with menstruation. It also may make it difficult to become pregnant.
What should I expect during recovery from LEEP?
After the procedure you may have:
- Watery, pinkish discharge
- Mild cramping
- Dark (brown–black) discharge, from the paste that is used
It will take a few weeks for your cervix to heal. While it is healing you should not put anything into the vagina, such as tampons, and you should not douche. You should also not have sexual intercourse. Your doctor will tell you when it is safe to have sex again. You should contact your gynecologist if you have any of the following problems:
- Heavy bleeding (heavier than your normal period)
- Bleeding with clots
- Severe abdominal pain
Will I need follow-up visits?
After the procedure you will need follow-up visits with your doctor. You will have Pap tests to make sure that all the abnormal cells are gone and that they have not come back. You will probably have a Pap test every 6 months until you have had three normal results. If you have another abnormal Pap test result, you may need further treatment. You can help protect the health of your cervix by following these guidelines:
• Have regular gynecological examinations and Pap tests.
• Stop smoking — smoking increases the risk of cancer of the cervix.
• Limit your number of sexual partners and use condoms to reduce the risk of sexually transmitted infections.