A Loop Electrosurgical Excision Procedure, commonly known as LEEP, is a medical procedure that uses a thin, heated wire loop to remove abnormal tissue from the cervical surface. The cervix is the lower, narrow part of the uterus that connects to the vagina. The primary aim of a LEEP is to remove these abnormal cells, which may be precancerous, to prevent them from potentially developing into cervical cancer.
Understanding the LEEP Procedure
The LEEP procedure typically takes 10 to 20 minutes. However, the total time spent at the clinic or doctor’s office will be longer, allowing for preparation and a brief recovery period. Many LEEP procedures are performed in an outpatient setting, such as a gynecologist’s office or clinic.
During the procedure, you will lie on an exam table in a position similar to a regular pelvic exam. A speculum will be inserted, providing a clear view of the cervix. A specialized solution, such as acetic acid or iodine, may be applied to the cervix to highlight any abnormal cells, causing them to turn white and become more visible.
A healthcare provider will then administer a local anesthetic to numb the cervix. While the numbing medication prevents pain, you might feel a slight pinch or sting as it is injected, and some pressure or mild cramping can occur. A grounding pad is typically placed on your thigh to ensure safety during the use of the electrical current.
Once the area is numb, a thin wire loop, heated by an electrical current, is guided across the surface of the cervix to remove the abnormal tissue. This process may involve one or more passes of the loop. After the abnormal cells are removed, a medicated paste is often applied to the treated area to help control any bleeding. The removed tissue is then sent to a laboratory for examination to check for precancerous or cancerous cells.
Before Your LEEP Procedure
Preparing for a LEEP procedure involves following specific instructions from your healthcare provider. It is generally recommended to avoid using tampons, douches, or vaginal creams for at least 24 to 48 hours beforehand.
You should also refrain from sexual intercourse for a day or two prior to the procedure. It is important to inform your healthcare provider about all medications you are taking, including over-the-counter drugs and herbal supplements, as some, like blood-thinners or aspirin, may need to be stopped temporarily. Scheduling the LEEP when you are not on your menstrual period is usually preferred.
Your healthcare provider may advise taking an over-the-counter pain reliever about 30 minutes to an hour before the procedure to manage potential cramping. You might also be asked to take a pregnancy test before the procedure, and it is important to notify your provider if you are pregnant or suspect you might be.
After Your LEEP Procedure
Following a LEEP, it is common to experience mild discomfort and discharge as your cervix heals. You may have mild cramping, similar to menstrual cramps, for a few days, which can be managed with over-the-counter pain relievers like ibuprofen or acetaminophen. Vaginal discharge or spotting is also expected and can last for one to three weeks. This discharge may initially be greenish-yellow, then turn brownish-black, and might have an unpleasant smell.
Follow post-operative care instructions. You should avoid inserting anything into the vagina, including tampons, douches, or sex toys, and refrain from sexual intercourse for at least four weeks. While showering is generally permitted, it is recommended to avoid baths, swimming, or soaking in hot tubs for two to four weeks.
Activity restrictions are advised. You should avoid strenuous physical activity and heavy lifting for at least two days, and potentially for one to two weeks, depending on your provider’s advice. Contact your healthcare provider if you experience heavy bleeding that soaks more than one pad an hour, severe abdominal pain, a fever, or vaginal discharge with an increasingly foul odor, as these could indicate an infection.
Why a LEEP Procedure is Performed
A LEEP procedure is performed to remove abnormal or precancerous cells from the cervix. These cells, often referred to as cervical dysplasia, are typically identified during routine screenings like a Pap test or a colposcopy. While cervical dysplasia is not cancer, it can progress to cervical cancer if left untreated over time.
The procedure serves as both a diagnostic and a treatment tool. It allows for the removal of the abnormal tissue, which is then sent to a laboratory to confirm the presence and extent of precancerous or, in some cases, cancerous cells. This provides information for further medical management. By removing these cells, LEEP acts as a preventative measure, reducing the risk of cervical cancer developing.
LEEP may also be recommended if abnormal cells persist after other treatments, or in cases involving cervical polyps or genital warts that are linked to human papillomavirus (HPV). The effectiveness of LEEP in removing precancerous cells is high.