Loop Electrosurgical Excision Procedure (LEEP)

LEEP uses 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 surface cells. In most cases, LEEP is an outpatient procedure that can be done in a doctor's office or a clinic in just a few minutes.

The Procedure
As with a pelvic examination, you lie on you back with your feet on the rests. The doctor will insert a speculum into your vagina. The loop is inserted through the vagina to the cervix.

The procedure should not be done during a menstrual period because the flow of blood makes seeing difficult. You may be given pain medication before the doctor begins.

A mild acetic acid solution (like vinegar) is applied to your cervix to show the abnormal cells. Colposcopy will be used to magnify the cervix during the procedure.

Your cervix will be numbed with a local anesthetic given through a needle attached to a syringe. You will remain awake, and you may feel a dull ache or cramp. After the procedure, a special paste may be applied to your cervix to stop any bleeding. The tissue that is removed will be studied in a lab for diagnosis.

Reasons for LEEP
Cells on the cervix sometimes become abnormal, a change that may be an early warning for cancer. When tests show that you have abnormal cells on your cervix, your doctor may suggest the loop electrosurgical excision procedure (LEEP). LEEP is used to remove abnormal cells from your cervix.

The cervix is covered by a thin layer of tissue like skin. The cells that make up this tissue grow all the time. During this growth, the cells at the bottom layer slowly move to the surface and are shed.

If this normal process changes in some way, cells become abnormal, a condition known as dysplasia. In mild forms, this condition may go away on its own. If it is severe or does not go away, it may lead to cancer of the cervix. Smoking and exposure to sexually transmitted diseases (STDs) also increase the risk for cancer of the cervix.

A Pap test detects changes in the cervix. Tests such as colposcopy and biopsy are used to discover the cause of those changes.

Treating Dysplasia
LEEP can be used to remove dysplasia (abnormal cells), allowing new healthy cells to grow. Dysplasia can also be treated with cryosurgery, electrocautery, laser, or cone biopsy. The choice of method is determine by how much cervical tissue needs to be removed and where the abnormal cells are located on the cervix.

Risks
You may feel faint during the procedure or have some bleeding. Electrocautery may be used to control bleeding. You may develop an infection after the procedure. These complications are rare and can be treated easily.

You should contact your doctor if you have any of the following:

Heavy bleeding (more than your normal period)
Bleeding with clots
Severe abdominal pain
Fever (more than lOO.4°F)
Foul-smelling discharge

Recovery
Your cervix may take a few weeks to heal. During this time, you may have:

Vaginal bleeding (less than a normal menstrual flow)
Mild cramping
A brownish-black discharge (from the paste used)

For a few weeks after the procedure, you should not have sex or use tampons or douches. If you have any discomfort, your doctor may prescribe pain medication.

Staying Healthy
To check on the health of your cervix, you will need to have several pelvic examinations during the year after you have had a LEEP. After 1 year of normal results, you may return to having exams once a year. If you have another abnormal Pap test, you may need more treatment.

You can protect the health of your cervix with a few lifestyle changes:

Have regular pelvic exams and Pap tests
Stop smoking
If you have more than one sexual partner, limit your number of partners and use condoms to reduce your risk of STDs