LEEP (Loop Electrosurgical Excision Procedure)

What is a LEEP Procedure

If your doctor has told you that you need to have a LEEP procedure, it’s because your annual Pap smear indicated the presence of abnormal cervical cells, or cervical dysplasia. The LEEP procedure is one of several procedures your doctor has available to help diagnose and treat abnormal cervical cells. Other procedures your doctor may want you to have either before or during the LEEP procedure include, a colposcopy and or/ a cone biopsy.

LEEP uses a thin wire loop electrode which is attached to an electrosurgical generator. The generator transmits a painless electrical current that quickly cuts away the affected cervical tissue in the immediate area of the loop wire. This causes the abnormal cells to rapidly heat and burst, and separates the tissue as the loop wire moves through the cervix.

This technique allows your physician to send the excised tissue to the lab for further evaluation which insures that the lesion was completely removed, as well as allowing for a more accurate assessment of the abnormal area.

You may want to ask your doctor if it’s OK to take an over-the-counter pain reliever such as ibuprofen before your procedure to help minimize any pain. Never take any drug before any medical procedure without explicitly asking your doctor about it. Always follow your doctor’s instructions for preparation for the LEEP.

What happens during the LEEP procedure?

The LEEP procedure takes about 20-30 minutes and is usually performed in your physician’s office. In some ways it may seem much like a normal pelvic exam because you will lie on the exam table with your feet in the stirrups. A colposcope will be used to guide your doctor to the abnormal area. Unlike a normal colposcopy, a tube will be attached to the speculum to remove the small amount of smoke caused by the procedure.

An electrosurgical dispersive pad will be placed on your thigh. The pad is a gel-covered adhesive electrode which provides a safe return path for the electrosurgical current. A single-use, disposable loop electrode will be attached to the generator hand piece by your physician. Your cervix will be prepared with acetic acid and iodine solutions that enable your physician to more easily see the extent of the abnormal area. Next a local anesthetic will be injected into the cervix; the electroloop will be generated and the wire loop will pass through the surface of your cervix.

After the lesion is removed your physician will use a ball electrode to stop any bleeding that occurs; he may also use a topical solution to prevent further bleeding. You can leave your physician’s office soon after the procedure.

Are there any complications associated with the LEEP?

Complications are usually mild but can include:

  • mild pain or discomfort
  • bleeding

You should call your physician if you experience bleeding that is heavier than a normal period, or if pain is severe. Other symptoms that should be reported to your physician include any heavy vaginal discharge or strong vaginal odor.

After the LEEP you should not:

  • Have sexual intercourse for as long as recommended by your physician
  • Lift heavy objects
  • Use tampons
  • Douche
  • Take tub baths–take showers only to prevent infection

It’s important for you to remember that having cervical dysplasia does not mean that you have cervical cancer. However, treatment of the abnormal area is imperative to prevent abnormal cervical cells from developing into cervical cancer.

After the LEEP procedure, make sure to follow your doctor’s instructions precisely. Your doctor will tell you when to return for follow up Pap smears, and / or colposcopies. Keeping these follow up appointments is necessary to verify that all of the abnormal cervical tissues have been removed, as well as to make sure that if abnormal cervical cells redevelop they are caught early and treated appropriately.

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