How LEEP Addresses Cervical Changes
The Loop Electrosurgical Excision Procedure, or LEEP, is a common medical intervention designed to treat abnormal cells found on the cervix. This procedure involves using a thin wire loop heated by an electrical current to precisely remove a section of cervical tissue. The primary objective of LEEP is to eliminate these abnormal or precancerous cells, typically identified through routine Pap and HPV tests. Removing these affected cells helps prevent their potential progression into cervical cancer.
During a LEEP, the heated wire acts like a precise surgical tool, cutting away the targeted tissue while simultaneously sealing blood vessels to minimize bleeding. The removed tissue is then sent to a laboratory for detailed examination by a pathologist. This examination confirms the presence and severity of abnormal cells and ensures that the margins of the removed tissue are clear, meaning all abnormal cells have been excised. LEEP is considered a highly effective method for treating cervical dysplasia, with success rates often ranging from 73% to 99% in removing these precancerous growths.
LEEP’s Impact on the HPV Virus Itself
A LEEP procedure primarily addresses the consequences of Human Papillomavirus (HPV) infection, specifically the abnormal cervical cells it can cause. LEEP does not eliminate the HPV virus from the body. HPV is a viral infection residing within the basal cells of the skin and mucous membranes, which are deeper layers of tissue than what LEEP removes. The procedure physically excises a superficial layer of tissue containing the abnormal cells; it cannot eradicate the virus from the body’s entire system.
While removing infected cells from the cervix might reduce the virus concentration in that specific area, the virus can still be present in other cells or regions of the body. The body’s immune system remains the primary mechanism for clearing HPV infection over time. Most HPV infections are temporary, with about 90% clearing spontaneously within two years due to the immune system’s response. LEEP treats the cellular changes caused by HPV, not the viral infection itself.
What to Expect Regarding HPV After LEEP
After a LEEP procedure, individuals may still have an HPV infection, as the procedure targets abnormal cells rather than the virus itself. The body’s immune system will continue its work to clear any remaining HPV infection. It is possible for HPV to persist even after a successful LEEP, or for a new infection with the same or a different HPV strain to occur. Studies indicate that HPV persistence rates after LEEP vary, with some showing rates around 40.9% at six months, decreasing to 11.8% at 18 months.
Follow-up testing is a crucial part of post-LEEP care to monitor for persistent HPV or the recurrence of abnormal cells. This typically involves regular co-testing, which combines a Pap test to check for abnormal cells and an HPV test to detect the presence of the virus. A negative HPV test after LEEP is associated with a very low risk of developing further high-grade cellular changes. However, if HPV persists, particularly high-risk types like HPV 16, there is a higher chance of abnormal cells returning, necessitating closer monitoring.
Ongoing Management and Prevention
Ongoing management and prevention are essential for individuals who have undergone a LEEP procedure, focusing on long-term cervical health and HPV. Regular follow-up screenings, including Pap and HPV tests, are important as recommended by healthcare providers. Typically, this involves a follow-up appointment with co-testing within six to twelve months after the procedure, followed by annual or less frequent screenings if results remain normal.
Maintaining overall immune health can also support the body’s ability to manage HPV. The HPV vaccine plays a significant role in preventing future infections with vaccine-preventable HPV strains. Even for individuals who have had a LEEP, vaccination can help protect against new infections from different HPV types or re-infection with cleared types, potentially reducing the risk of recurrence of abnormal cells. Studies show a reduction in recurrent cervical dysplasia among women who received the HPV vaccine after LEEP.