What is loop electrosurgical excision procedure?

A loop electrosurgical excision procedure (LEEP) removes tissue from the cervix. You may have this done if you've had a Pap test or colposcopy that shows tissue that isn't normal.

During LEEP, your doctor will put a tool called a speculum into your vagina. It opens the vagina a little bit. This lets your doctor see the cervix and inside the vagina. A special fluid is sometimes put on your cervix to make certain areas easier to see.

You may get a shot of medicine to numb the cervix. You may feel cramps when you have the shot. You may also get pain medicine.

Your doctor will put a device with a fine wire loop into your vagina. The doctor uses the heated wire to cut out tissue. After the procedure, another doctor will look at the tissue under a microscope and check it for abnormal cells.

You may have mild cramps for several hours after LEEP. A dark brown discharge during the first week is normal. You may have some spotting for about 3 weeks.

LEEP is done in a doctor's office, a clinic, or a hospital. It takes only a few minutes. You can go home after the procedure.

You can probably return to your normal routine in about a week. How long it takes you to recover will depend on how much was done.

Activity

• You can probably return to your normal routine in about a week. How long it takes you to recover will depend on how much was done.
• Try to walk each day. You can resume regular exercise when you are feeling better.

Medicines

• Your doctor will tell you if and when you can restart your medicines. The doctor will also give you instructions about taking any new medicines.
• If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
• Take an over-the-counter pain medicine, such as acetaminophen (Tylenol), ibuprofen (Advil, Motrin), or naproxen (Aleve). Read and follow all instructions on the label.
• Do not take two or more pain medicines at the same time unless the doctor told you to. Many pain medicines have acetaminophen, which is Tylenol. Too much acetaminophen (Tylenol) can be harmful.

Other instructions

• Use a sanitary pad if you have bleeding.
• Do not have vaginal sex or place anything in your vagina for 2 to 4 weeks after the procedure or until your doctor tells you it is okay. Do not douche.
• You can take a shower anytime after the procedure. Ask your doctor when it is okay to take a bath.
• Depending on the biopsy results, you will have regular follow-up HPV tests, Pap tests, or colposcopic exams. Your doctor will tell you what follow-up tests you should have and when you need to have them done.

LEEP works very well to treat abnormal cell changes on the cervix.

If all of the abnormal tissue is removed, you won't need more surgery. In most cases, doctors are able to remove all the abnormal cells. But abnormal cells may come back in the future.

Procedures can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for your procedure.

Preparing for the procedure

• Tell your doctor if:
  • You are having your menstrual period.
  • You are or might be pregnant. A blood or urine test may be done to see if you are pregnant.
• Understand exactly what procedure is planned, along with the risks, benefits, and other options.
• If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your procedure. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
• Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your procedure. Your doctor will tell you if you should stop taking any of them before the procedure and how soon to do it.

Most people don't have problems after LEEP. But there are some risks.

• A few people may have serious bleeding that requires further treatment.
• Infection of the cervix or uterus may develop (rare).
• Narrowing of the cervix (cervical stenosis) that can cause infertility may occur (rare).
• The cervix may not stay closed during pregnancy (incompetent cervix). Having LEEP may increase the risk of miscarriage or preterm delivery.

You may have:

• Mild cramping for a few hours after the procedure.
• A dark brown vaginal discharge during the first week.
• Vaginal discharge or spotting for about 3 weeks.

Do not have vaginal sex or place anything in your vagina for 2 to 4 weeks after surgery or until your doctor tells you it is okay.

You can probably return to your normal routine in about a week. But how long it takes you to recover will depend on how much was done.

Depending on the biopsy results, you will have regular follow-up testing with HPV tests, Pap tests, or colposcopic examinations. Your doctor will tell you what follow-up tests you should have and when you need to have them done.

LEEP removes tissue from the cervix. Your procedure removed abnormal tissue from your cervix.

You may have mild cramping for several hours after the procedure. A dark brown vaginal discharge during the first week is normal. You can use a sanitary pad for the bleeding.

You may also have some spotting for about 3 weeks. How long it takes to recover will depend on how much was done during the procedure.

• You may eat or drink as you normally do.
• You may want to take a pain reliever, such as ibuprofen (Advil or Motrin), 30 to 60 minutes before you have the procedure. This can help reduce any cramping pain.

At the doctor's office or hospital

• Bring a picture ID.
• You will be kept comfortable and safe by your anesthesia provider. You may get medicine that relaxes you. The area being worked on will be numb.
• The procedure will take about 15 to 30 minutes.

LEEP may be used to treat cell changes on the cervix. It can also help to diagnose abnormal cells. The tissue that is removed during LEEP can be checked for abnormal cell changes or cancer.