LEEP Procedure & Cold Knife Cone Biopsy

What is a LEEP Procedure and Cold Knife Cone Biopsy?

If your doctor finds precancerous cell changes in your cervical tissue, also known as cervical dysplasia, the area around the tissue may need to be surgically removed to reduce the risk of cancer and its spread. There are two common ways this can be done: a cold knife cone biopsy and a Loop Electrosurgical Excision Procedure (LEEP Procedure).

Both of these procedures can be used to treat abnormal tissue that your doctor has found during a colposcopy or cervical biopsy, including:

• Moderate-severe precancerous cell changes
• Low-grade squamous intraepithelial lesions (LSIL). These are minor cell changes that do not resolve after a few months.

Cold Knife Cone Biopsy

This procedure is typically performed in the hospital. You will be administered a general anesthetic, which will put you to sleep and keep you from feeling any pain during the procedure.

With you on your back, the surgeon will insert a speculum into your vagina to access the cervix. Then, the surgeon will use a surgical knife to remove a small, cone-shaped sample of tissue from the cervix. The sample can be evaluated in the lab for signs of cancer. The surgery aims to remove abnormal tissue before the dysplasia becomes cancerous.

How is the LEEP performed?

A LEEP can usually be performed in your gynecologist’s office. However, it is sometimes recommended to perform it at a surgery center.

During the procedure, you will lie on your back with your feet in stirrups. Using a speculum, your doctor will open your vagina to gain access to your cervix, much like during a regular pelvic exam. The doctor will then inject a numbing agent into your cervix.

This is known as a cervical block, and it can also be used in combination with oral or intravenous pain medication. Additionally, Dr. Aliabadi often uses Nitrous Oxide (aka “laughing gas”) while performing this procedure to minimize pain as well as anxiety greatly.

The LEEP instrument is an electrified wire loop at the end of a narrow wand. The loop can easily pass through your cervical tissue to remove a small sample, which can be tested for cancer. The goal of the procedure is to remove the abnormal cells to decrease the chances of cancer.

What do my LEEP results mean?

When a sample of abnormal cervical tissue is removed via LEEP or cold knife cone biopsy, it is sent to the lab for testing. Within a few days, your doctor can tell you the results. If your results were abnormal, that means that there are areas of cancerous or precancerous cell changes in your cervix. This is often detected in a colposcopy/cervical biopsy before the procedure.  Precancerous cervical cells are known as Cervical Intraepithelial Neoplasia (CIN), and there are three grades of severity.

• CIN I – Mild dysplasia
• CIN II – Moderate dysplasia
• CIN III – Severe dysplasia or carcinoma

What are the risks of the LEEP Procedure and Cold Knife Cone Biopsy?

As far as surgical procedures go, these techniques are quite safe. There are, however, some risks involved that you should discuss with your doctor, including:

• Cervical stenosis. This is a complication in which the cervix narrows, making it more difficult to become pregnant naturally.
• Premature birth. Studies have shown that LEEP and Cold Knife Cone Biopsy can lead to a syndrome known as an incompetent cervix, which may result in a premature delivery if you become pregnant.
• Cervical scarring. Adhesions on the cervix may cause pain during your period, fertility problems, and delivery problems.
• Tissue damage, including damage to the bladder or bowel.
• Hemorrhaging
• Infection

What is the LEEP procedure recovery?

Neither procedure requires an overnight hospital stay. You may experience some unpleasant symptoms after your surgery, including:

• Mild cramping. You can take ibuprofen or use a heated pad to manage the pain.
• Vaginal discharge for 1-3 weeks
• Discharge that is dark or brown

Avoid putting anything into your vagina for the first 3-4 weeks. Abstain from sexual intercourse and use pads instead of tampons to absorb blood. Douching is not recommended.

Complications are rare, but you will want to call your doctor if you’re experiencing worsening symptoms or any signs of infections, such as:

• Fever, nausea
• Foul-smelling discharge
• Worsening pain
• Severe bleeding or clotting – going through at least one pad each hour

Schedule a follow-up appointment with your doctor about 3-4 months after your procedure. Your gynecologist may perform another pap smear to monitor the cells of your cervix.

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.

Why choose Dr. Aliabadi for your gynecological care

Aliabadi and her devoted gynecology and obstetrics team focus on women’s health care. When you visit Dr. Aliabadi, you will feel secure, valued, and well cared for. We encourage you to establish care with Dr. Aliabadi. You can make an appointment online or call us at (844) 863-6700.

Dr. Thais Aliabadi’s practice and Outpatient Hysterectomy Center are conveniently located for patients throughout Southern California and the Los Angeles area. We are near Beverly Hills, West Hollywood, Santa Monica, West Los Angeles, Culver City, Hollywood, Venice, Marina del Rey, Malibu, Manhattan Beach, and Downtown Los Angeles.