Loop Electrosurgical Excision Procedure
What is a LEEP?
Frontal view of cervix - The electrosurgical loop removes a thin layer of surface cells from the cervix
"LEEP" is an abbreviation for loop electrosurgical excision procedure. It is a way to test and treat abnormal cell growth on the surface tissue of the cervix. LEEP may be recommended after abnormal changes in the cervix are confirmed by Pap tests and colposcopy biopsies. (Colposcopy is a non-invasive procedure in which a device similar to a microscope is used to view the cervix.) LEEP allows your physician to remove the abnormal tissue and test it for cancer.
Abnormal cell growth on the surface of the cervix is called cervical dysplasia. Though cervical dysplasia is not cancer, over time it can worsen and lead to cancer.
How is LEEP performed?
LEEP begins much like a regular pelvic exam. Though you will remain awake throughout the procedure, you should feel only minor discomfort. First, you will be asked to lie back and rest your feet in stirrups at the end of the examination table. A speculum will be inserted into the vagina and opened so that the cervix can be seen. (Positioning for loop electrosurgical excision procedure).
Positioning for loop electrosurgical excision procedure
A solution is applied to the cervix to make the abnormal cells visible. Your physician then places a colposcope near the opening of the vagina. The colposcope, which remains outside of the vagina, provides a magnified view of the cervix.
The cervix is then numbed with local anesthesia. An electrically charged loop made of thin wire is inserted through the speculum and up to the cervix.
As the loop is passed across the cervix, it cuts away a thin layer of surface tissue, removing the abnormal cells. This tissue will be later tested for cancer or abnormal cells. Finally, a medicated paste is applied to the area to prevent bleeding.
How long does the procedure take?
The procedure takes 10 to 20 minutes to perform. You will be able to go home as soon as the procedure has been completed.
Are there other treatments for cervical dysplasia?
Yes. There are a number of ways your physician can remove abnormal tissue from the cervix. These methods include:
- Cryosurgery: The surface tissue is destroyed by freezing.
- Cold knife conization--Removal of a cone-shaped wedge of tissue from the cervix.
- Laser treatment or cone excision--Heat from a high-intensity beam of light is used to destroy or cut away abnormal tissue.
The treatment that is best for you will depend on factors such as the amount and location of the abnormal tissue.
Is LEEP safe?
Yes. LEEP is very safe. Complications are rare and the procedure can be completed without use of general anesthesia. However, there are some risks, such as infection and bleeding. Also, if a large area needs to be removed, or if there is need for multiple LEEP procedures, a doctor will check your cervix by ultrasound during any subsequent pregnancies. Sometimes the cervix is weakened by these procedures, leading to early delivery of a baby. Discuss any concerns you may have with your doctor.
Recovering at home
- Vaginal drainage or spotting is normal for 1 to 3 weeks following the procedure. The medication paste will produce a greenish-yellow discharge immediately after the procedure. A brownish-black vaginal discharge is also normal.
- Pads may be used for discharge. You should avoid placing anything in the vagina for 4 weeks, including tampons.
- Your menstrual cycle will not be disrupted by this procedure.
- Avoid excessive activity for 48 hours after the procedure. Refrain from exercising for at least 1 week. You can begin exercising again in 1 to 2 weeks. Stop exercising if bleeding other than normal menstruation occurs. If excessive bleeding occurs after you resume normal activities, call your physician.
- Abstain from sexual intercourse for 3 to 4 weeks.
- Showers are allowed.
During your recovery, you may experience vaginal bleeding and mild cramping. To relieve abdominal cramping, take a non-aspirin, over-the-counter pain reliever such as ibuprofen (Motrin®, Advil®) or acetaminophen (Tylenol®).
When to contact your physician
Contact your physician if you experience any of the following symptoms during your recovery:
- Heavy bleeding (more than a normal menstrual flow)
- Bleeding with clots
- Vaginal discharge that has a foul odor
- Fever over 100.4 degrees Fahrenheit
- Severe abdominal pain
© Copyright 1995-2014 The Cleveland Clinic Foundation. All rights reserved.
Can't find the health information you're looking for?
This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 11/3/2014...#4711