Frequently Asked Questions about the Loop Electrosurgical Excision Procedure (LEEP) answered by Los Angeles Obstetrician Dr. Thais Aliabadi
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Q: What is LEEP and how does it work?
LEEP stands for loop electrosurgical excision procedure, and it is a minimally-invasive surgery to remove abnormal cells from the cervix for testing or as treatment. LEEP is conducted using a long, narrow instrument with a thin, electrified wire loop at the end. The loop slices cells off the cervical surface.
Q: When is LEEP used?
Your gynecologist may recommend LEEP if you’ve had an abnormal Pap smear. Abnormal Pap results do not mean that you have cancer, but they are usually interpreted to mean that abnormal cell changes are present on the cervix, which is sometimes a precursor to cancer. Removing the cells with LEEP may prevent the problem becoming worse, regardless of whether or not you are experiencing any symptoms.
Q: How is LEEP performed?
LEEP is a simple, 5-10 minute outpatient procedure that can be performed right in your doctor’s office. Schedule your procedure on a day when you are not having your period.
Your doctor will ask you to undress from the waist-down, and lie on your back with your feet in stirrups, much like during a pelvic exam. A speculum – a slender, two-paddled instrument – will be inserted into your vagina to give your doctor a clear view of the cervix. You will receive a local anesthetic injected into the area.
Next, your doctor will insert the LEEP instrument to conduct the procedure. The sliver of tissue collected from your cervix can then be sent to the lab to test for abnormal cell changes. If there is any bleeding, your doctor can apply a thick brown-colored paste or electrocauterize the tissue.
Q: Is the LEEP procedure painful?
A local anesthetic is applied to numb the area. You may feel a stinging sensation when the anesthetic is injected into your cervix. You may also experience some aching or cramping during the procedure. If you feel faint at any time during the procedure, let your doctor know.
Q: What is the recovery from LEEP like?
It takes about 2-3 weeks to fully recover from the procedure. Avoid putting anything in your vagina, including tampons and douches. You should also avoid vaginal intercourse during this time. After receiving LEEP, you may experience:
- Light cramping
- Thin, blood-tinged discharge
- Brownish discharge mixed with the paste
Q: What are the risks of LEEP?
If you experience any bleeding heavier than your typical period, clotting, or severe pain, contact your gynecologist right away. You may be at risk for infection. Your doctor can reapply more paste to stop the bleeding.
Studies have shown a slight increase in the risk of preterm birth and low birth weight in women who have had LEEP. Most women, however, report no complications and go on to have full term pregnancies and healthy births.
There is also the small risk of cervical narrowing following the procedure. This could cause menstrual complications and fertility problems. Talk with your doctor about your concerns prior to your procedure. Let your doctor know of your future pregnancy plans.
Q: When should I see my doctor again?
You should schedule follow-up visits every 6 months after the procedure for regular Pap smears. After you’ve returned three normal tests, you can go back to your regular check-up routine. If your results are abnormal, you may need additional treatment.
Q: How can I decrease my risk of cervical cancer?
There are a few steps you can take to reduce your chances of cervical cancer.
- Get vaccinated against HPV. The Gardasil vaccine is recommended for women and men over the age of 9 to protect against the strains of HPV most likely to cause cervical cancer.
- Practice safe sex. Use condoms and limit your sexual partners.
- Quit smoking. Smoking harms your immune system, and has been shown to increase the risk of cervical cancer.
- Attend regular check-ups with your doctor.