Loop Electrosurgical Excision Procedure (LEEP)
While your annual pelvic exam isn’t the highlight of your year, it’s still something you have to do. Most often, you’ll get a clean bill of health and get on with your life. But if you ever do get an abnormal result, you want to know what’s going on — and fast.
That’s when you might need a loop electrosurgical excision procedure, otherwise known as a LEEP. When a cervical exam or Pap test reveals abnormal cells or growths, your gynecologist may order a cervical LEEP as a way to extract a biopsy, a thin amount of tissue, from the lower part of your genital tract, such as from your cervix and/or vagina.
The LEEP tool is a thin wire loop, through which an electric current passes. The device, heated by electricity, acts as a scalpel that can cut a very thin layer of tissue off the surface of your cervix or vagina. This tissue is then sent to a lab for analysis. After the LEEP has cut away abnormal tissue, the remaining healthy cells can continue to grow.
Why a LEEP Is Beneficial
Your doctor uses the LEEP because he wants to know if the abnormal cells discovered in your initial exam are cancerous, precancerous or just an anomalous reading. A trained gynecologist can use the results to make an accurate diagnosis of your current condition. From the diagnosis, a treatment plan, if one is needed, can be put in place.
Other reasons your doctor may want you to take a LEEP include testing for the following:
- Genital warts, which are often benign, but which may point to a human papilloma virus infection. This test is called the HPV LEEP, and it’s important because HPV is one of the early risk signs of cervical cancer. Just because you have genital warts doesn’t mean you have or are getting cancer, but your doctor wants to be sure.
- Endometrial polyps, which are always benign growths, but which can still interfere with your ability to get pregnant since they appear in your uterus and cervix. Your doctor can remove any large polyps with the LEEP.
- Diethylstilbestrol, which is the drug known as DES. According to the Centers for Disease Control and Prevention, 5 to 10 million pregnant women were prescribed DES in the mid-twentieth century, but it was later discovered that DES raised the rate of reproductive system cancers.
Preparing for the LEEP
You prepare for the LEEP as you would for a normal pelvic exam. You shouldn’t undergo a LEEP during your period because your OBGYN needs a clear view of your cervix. The whole procedure takes only a few minutes and can be done in your doctor’s office. Most often a LEEP is done on your cervix, but it may also be performed on your vagina walls or in your uterus. This procedure describes a cervical LEEP.
Your OBGYN places a speculum in your vagina to expose your cervix. A colposcope, positioned just outside your vagina, allows the doctor to get a clearer view. Then your cervix is cleaned and bathed in a vinegar solution, which may burn a little. The solution turns any abnormal tissue white. Sometimes a Schiller test follows, in which your doctor dabs an additional iodine solution on your cervix.
Next, your OBGYN applies a local anesthetic to the area through a syringe. You may feel some discomfort, but you won’t feel any LEEP procedure pain. Once the anesthetic is working, your doctor can begin the loop electrosurgical excision procedure.
The LEEP Steps
Passing the LEEP wire loop through the speculum and into your vagina, your gynecologist may make several passes at your cervix to remove the abnormal tissue. If you feel faint during this part of the procedure, tell your doctor because it’s important that you keep as still as possible while he works. During the LEEP, the electrical current cauterizes the blood vessels, so you won’t lose much blood.
How much tissue your OBGYN removes depends on the purpose of the LEEP. A biopsy requires very little tissue, but if the goal is to remove the abnormal tissue so healthy tissue can grow in its place, your doctor may have to remove more. When finished, a special paste can control any bleeding that the cauterization didn’t stop.
After the LEEP
While you rest, your OBGYN will send the tissue sample to a lab for analysis. It’s recommended that you wear a sanitary pad in case you bleed on the way home. You may need a mild pain reliever for the pain, but don’t take aspirin, which thins your blood and can encourage bleeding. Other consequences of the LEEP include:
- Some cramping
- Red-pink spotting
- A blackish discharge, which comes from the paste used to stop the bleeding
All of these are normal and will stop in time. Follow your doctor’s instructions for your recovery. You may be directed to:
- Not douche or use tampons
- Abstain from sex after LEEP procedure for at least three or four days or as your doctor advises
- Avoid strenuous activities, such as jogging or heavy lifting
Your cervix may need two to four weeks to fully heal. Your OBGYN will let you know when you can resume these activities and get back to your normal lifestyle. You may need to get Pap tests more frequently in the future because an abnormal Pap after LEEP may mean you’ll have to undergo another loop electrosurgical excision procedure.
LEEP Side Effects
The most common side effect from a LEEP during your recovery period is some heavier-than-normal bleeding. It’s usually not life threatening. In fact, your OBGYN can put more of the special paste on your cervix to stop it. But if you notice any of the following symptoms, contact your doctor right away:
- A fever with or without chills
- Bleeding that has clots
- Seepage from your vagina that smells bad
- Acute cramping or pain in your abdomen
Most women have no problem with pregnancy after LEEP, but there have been reports of a higher incidence of premature births or babies who have a lower-than-average weight. Very rarely, the LEEP causes problems with your menstrual cycle that does make it harder to get pregnant, but again, this is a very rare occurrence.
Symptoms should always be evaluated with a thorough consultation and examination by your gynecologist for an accurate diagnosis and treatment plan to exclude any underlying serious condition.
Important Reminder: This information is only intended to provide guidance, not a definitive medical advice. Please consult ob/gyn doctor about your specific condition. Only a trained, experienced board certified gynecologist can determine an accurate diagnosis and proper treatment.
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