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  • Michael Frey, MD

LEEP

A LEEP (loop electrosurgical excision procedure) procedure treats abnormal cell growth on the cervix before it progresses to cancer.



LEEP is done after abnormal changes in the cervix are confirmed by Pap tests and colposcopy biopsies.


How is LEEP (loop electrosurgical excision procedure) performed? LEEP begins much like a regular pelvic exam. Though you will remain awake throughout the procedure, you should feel only minor discomfort. First, you will be asked to lie back and rest your feet in stirrups at the end of the examination table. A speculum will be inserted into the vagina and opened so that the cervix can be seen. A very dilute solution of acetic acid or Lugol’s solution (Iodine) is applied to the cervix to make the abnormal cells visible.

The cervix is then numbed with local anesthesia. This may cause tingling in the tongue, ringing in your ears or a rapid heart rate. If this occurs, it lasts for only a few minutes. Once the cervix is numb, an electrically charged loop made of thin wire is inserted through the speculum and up to the cervix.

As the loop is passed across the cervix, it cuts away a thin layer of surface tissue, removing the abnormal cells. Sometimes a second loop is used to go a little higher up the cervix. This tissue will be later tested for cancer or abnormal cells as well as the proximity of the abnormal cells to the edge of the tissue that was removed (the margins).

Finally, a medicated paste (an iron solution called Monsel’s paste) is applied to the area to stop and prevent bleeding.


How long does the procedure take? The procedure takes 10 to 20 minutes to perform. You will be able to go home as soon as the procedure has been completed.


RECOVERY AND OUTLOOK What can I expect when recovering at home after LEEP (loop electrosurgical excision procedure)?

  • Vaginal drainage or spotting is normal for one to three weeks following the procedure. The medication paste will produce a greenish-yellow discharge immediately after the procedure which may have a mild odor. A brownish-black vaginal discharge is also normal.

  • Pads may be used for discharge. You should avoid placing anything in the vagina for four weeks, including tampons.

  • Your menstrual cycle will not be disrupted by this procedure.

  • Avoid excessive activity for 48 hours after the procedure. Refrain from exercising for at least one week. You can begin exercising again in one to two weeks. Stop exercising if bleeding other than normal menstruation occurs.

  • Abstain from sexual intercourse for two weeks.

  • Showers are allowed.

How do I relieve discomfort after LEEP (loop electrosurgical excision procedure)? During your recovery, you may experience vaginal bleeding and mild cramping. To relieve abdominal cramping, take a non-aspirin, over-the-counter pain reliever such as ibuprofen (Motrin®, Advil®) or acetaminophen (Tylenol®).


WHEN TO CALL

  • Heavy bleeding (more than a normal menstrual flow)

  • Bleeding with clots

  • Vaginal discharge that has an increasingly foul odor

  • Fever over 100.4 degrees Fahrenheit

  • Severe abdominal pain




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