What is a LEEP?
LEEP stands for loop electrosurgical excision procedure. It’s used to remove abnormal cells from your cervix.
To do this, your doctor uses a small wire loop. The tool is charged with an electrical current. The current heats the loop, allowing it to act as a surgical knife.
Keep reading to learn more about why this procedure is done, potential risks, how to prepare, and more.
Who gets the procedure?
Removing the cells will allow your doctor to determine what they are and whether further observation or treatment is needed.
If you have pelvic inflammatory disease or acute cervix inflammation, your doctor may advise against a LEEP. A cone biopsy, which is done surgically, might be a better choice for you. Some doctors will recommend a laser procedure or cryotherapy, in which the area of concern is frozen, and subsequently dies and sloughs off.
Are there any risks?
LEEP is safe and effective. Still, there are some risks.
- bleeding during or after the procedure, though the tool helps seal the surrounding blood vessels to minimize this risk
- scarring on the cervix, depending on the amount of tissue the doctor needs to remove
- difficulty getting pregnant in the year after the procedure
How to prepare for the procedure
You should schedule your LEEP for the week after your period ends. This will allow your doctor to see your cervix clearly and better monitor any bleeding caused by the procedure.
If you’re still menstruating on the day of your procedure, you’ll need to reschedule.
You shouldn’t take any medications that contain aspirin for five to seven days before your procedure, or as directed by your doctor. Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) can increase your risk of bleeding during the procedure.
There’s no need to fast before a LEEP, so feel free to eat and drink beforehand.
You may experience bleeding after the procedure, so make sure you bring a sanitary napkin to your appointment. If you don’t have one, your doctor may be able to provide you with some samples.
What to expect from the procedure
Your LEEP can be performed at your doctor’s office. The procedure takes about 10 minutes, though you may be in the room for about 30 minutes total.
Your doctor or nurse will show you the equipment, explain the procedure, and ask if you have any questions or concerns.
After you sign any necessary paperwork, you’ll have the opportunity to use the restroom one last time. You’ll also be asked to change into a hospital gown.
When it’s time to begin, you’ll get into the same position as for a pelvic exam — laying on your back on the exam table with your feet in the stirrups.
Your doctor or nurse will place a grounding pad on your thighs to protect you from electrical shocks that can happen in the treatment room.
Your doctor will insert a speculum into your vagina to spread the walls of your vaginal canal and provide a clear view to your cervix. They may also use a colposcope to magnify the tissue of your cervix.
Next, your doctor will clean your cervix with a vinegar solution. The solution will turn any abnormal tissue white so that it can be seen more easily.
They may opt to use iodine in place of vinegar. Iodine will stain normal cervical tissue brown, allowing abnormal cells to be easily seen.
Your doctor will inject a local anesthetic to numb your cervix before beginning the removal process.
After your cervix is numb, your doctor will pass the wire loop through the speculum and begin to scrape away any abnormal tissue. You may feel some pressure or slight cramping.
Let your doctor know if you experience severe pain or feel faint. They may be able to apply more anesthetic.
After the abnormal cells are removed, your doctor will apply a paste-like medication to stop any bleeding.
Your doctor will likely ask you to rest for 10 to 15 minutes. During this time, they’ll advise you on any next steps and tell you what to expect from recovery.
Your doctor will send the tissue they removed to a lab for testing. Results should be back to your doctor within 10 days or sooner.
What to expect during recovery
Your doctor will tell you everything you need to know about aftercare and recovery.
It’s normal to experience brown or black discharge afterward, so be sure to wear a sanitary napkin. You may find that your next period is late or heavier than normal.
You shouldn’t use tampons, menstrual cups, or anything else that’s inserted into the vagina for about four weeks. You must also refrain from vaginal intercourse or penetration during this time.
You should also avoid strenuous activity or heavy lifting for about a week after the procedure.
You can take acetaminophen (Tylenol) to ease any discomfort, but you should avoid NSAIDs like aspirin (Bayer) until your doctor says they’re safe to take.
Call your doctor right away if you experience:
- heavy bleeding in the weeks after a LEEP
- smelly vaginal discharge
- severe belly pain
- a fever of 101°F (38.3°C) or higher
These could be signs of infection, which requires immediate treatment.
Your doctor will help you set up a follow-up exam to go over your LEEP results. You may be told that there is no further cause for worry, but you will also be asked to follow up with PAP tests. Follow your doctor’s advice. The specific results, types of cells, your age, and family history will be considered as your health care provider follows the American College of Obstetricians and Gynecologists guidelines. Do your research and become informed.
In the future, you may need more frequent Pap tests. Regular pelvic exams can help you maintain the health of your cervix.