Loop Electrosurgical Excision Procedure

Loop electrosurgical excision procedure (LEEP) uses a wire loop heated by electric current to remove cells and tissue as part of the diagnosis and treatment for abnormal or cancerous conditions in a woman’s lower genital tract.

The lower genital tract includes the cervix and vagina. The cervix is the lower, narrow part of the uterus (womb) and the vagina connects the cervix and the vulva (the external genitalia).

With LEEP, an electric current passes through the fine wire loop to cut away a thin layer of abnormal tissue. This tissue will be sent to the lab for examination. LEEP can also remove abnormal cells to allow healthy tissue to grow.

Other related procedures that may be used to diagnose cervical and vaginal conditions include Pap test, cervical biopsy, and colposcopy. Please see these procedures for additional information.

How Effective Is LEEP?

LEEP cures the problem about 90 percent of the time.

If LEEP does not cure your problem, you may have LEEP again, or your health care provider may recommend another treatment.

How Does LEEP work?

During the LEEP procedure, the health care provider usually looks through a colposcope to see your cervix more clearly.

  • You lie down on an exam table in the same position used to have a Pap test.
  • A speculum — a metal or plastic instrument — is inserted into your vagina to separate the walls.
  • A numbing medication is injected into your cervix.
  • A vinegar-like solution is applied to make the abnormal cells more visible.

The health care provider uses an electrical wire loop to remove the abnormal tissue. The tissue is sent to a lab to be tested.

Blood vessels on the area are sealed to prevent bleeding. The health care provider may also apply a special paste — Monsel’s Solution — to prevent bleeding.

A LEEP procedure takes about 10 minutes.

Reasons for the procedure

LEEP may be performed when cervical or vaginal problems are found during a pelvic examination, or abnormal cells are found during a Pap test. LEEP is also performed to detect cancer of the cervix or vagina.

Cells that appear to be abnormal, but are not cancerous at the present time, may be identified as precancerous. The appearance of these abnormal cells may be the first evidence of cancer that could develop years later.

LEEP may also be used to assist in the diagnosis or treatment of the following conditions:

Polyps (benign growths)

Genital warts, which may indicate infection with human papilloma virus (HPV), a risk factor for developing cervical cancer

Diethylstilbestrol (DES) exposure in women whose mothers took DES during pregnancy, as DES exposure increases the risk for cancer of the reproductive system

There may be other reasons for your health care provider to recommend LEEP.

Risks of the procedure

As with any surgical procedure, complications may occur. Some possible complications may include, but are not limited to, the following:

  • Infection
  • Bleeding
  • Changes or scarring in the cervix from removal of tissue
  • Difficulty getting pregnant
  • Potential for preterm birth or having a low birth weight baby
  • Patients who are allergic to or sensitive to medications, iodine, or latex should notify their health care provider.
  • If you are pregnant or suspect that you may be pregnant, you should notify your health care provider.

There may be other risks depending on your specific medical condition. Be sure to discuss any concerns with your health care provider prior to the procedure.

Certain factors or conditions may interfere with LEEP. These factors include, but are not limited to the following:

  • Menstruation
  • Acute pelvic inflammatory disease
  • Acute inflammation of the cervix

What Should I Do to Prepare for LEEP?

Try to schedule the LEEP procedure for shortly after the end of your period. This will give your cervix time to heal before you have your period again.

Ask your health care provider if you should take an over-the-counter pain reliever about an hour before your procedure to reduce the chance of discomfort.

What Can I Expect After the Procedure?

After the LEEP procedure, you may feel mild cramping for a day or so. If you’re uncomfortable, use oral pain relievers, such as acetaminophen (like Tylenol) or ibuprofen (like Advil).

You probably will have a watery discharge for several weeks. It may be heavy and may be mixed with a little blood. There also may be some odor to the discharge.

In addition to normal bathing, wash your labia (lips of the vulva) with plain water several times a day for a few days.

Do not douche or use tampons for several weeks after having the LEEP procedure — talk with your health care provider about how long you should wait.

Your health care provider will help you decide how long you should wait to have sex again. In general, women should wait 3–4 weeks after having the LEEP procedure before having vaginal intercourse.

This allows the cervix time to heal and reduces the risk of infection. You can enjoy other kinds of sex that doesn’t involve inserting anything into your vagina.

Continue taking your medications as usual — including the birth control pill. You can also continue to use any other method of birth control.

Is LEEP Safe?

Most women do not have any serious side effects after the LEEP procedure.

Rare complications of LEEP include

  • damage to other pelvic organs or the wall of the vagina
  • heavy bleeding
  • pelvic infection — particularly if you have sex before the cervix heals
  • reaction to local anesthesia

You should call your health care provider if you have

  • abdominal pain
  • fever or chills
  • vaginal discharge that smells very bad
  • heavy bleeding

LEEP may increase the risk of preterm birth in future pregnancies. Talk with your health care provider if you plan on getting pregnant in the future.

LEEP During Pregnancy

Health care providers usually try to wait until after birth to treat a pregnant woman’s abnormal cervical cells. Delaying treatment is usually safe because it generally takes a long time for abnormal cervical cells to become cancerous.

Are There Other Treatments for Abnormal Cervical Cells?

Yes. Other treatments include

  • laser — A laser beam is used to destroy or cut away abnormal tissue.
  • cryotherapy — A very cold chemical freezes off abnormal tissue.
  • cone biopsy — A cone-shaped wedge is cut out of the cervix. It is tested in a lab. Cone biopsy is used to diagnose and treat abnormalities that go deeper into the cervix. It is usually performed in an operating room under anesthesia.

Another way to manage abnormal cervical cells is to monitor them and see if treatment is necessary. Your health care provider may recommend more frequent Pap tests and follow-up colposcopies to see if the cells heal themselves.

Your health care provider can discuss your best treatment plan with you.

Source & More Info: Hopkins Medicine and plannedparenthood.org

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