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LEEP

If you receive an abnormal colposcopy result, a health care provider may recommend that you have a loop electrosurgical excision procedure, commonly referred to as LEEP.

 

What is a LEEP?

A LEEP involves removing abnormal tissue from your cervix using a thin wire loop. It is usually done within eight weeks of diagnosis. More than 9 out of 10 patients will only require one LEEP to remove any abnormal tissue.

What happens during a LEEP?

  1. The health care provider will take a look at your cervix using a special microscope called a colposcope.
  2. A small amount of vinegar or iodine will be placed on your cervix to make any abnormalities more visible. You may feel a mild burning or tingling sensation. 
  3. Local freezing is then used to numb the cervix, which is normal. Some people feel a pinch or cramp when the freezing is done. The freezing medication will make your heart beat a little faster, but it’s not dangerous, and it will pass within a few minutes.
  4. A thin wire loop is then used to remove abnormal tissue. The procedure usually lasts less than five minutes.
  5. To reduce any bleeding, a brown paste may be placed on the cervix. The paste comes out later looking brown or black, which is normal.

What happens after my LEEP?

Most patients have no symptoms after a LEEP.  You may experience cramps, light vaginal bleeding, or watery vaginal discharge for a few weeks. Avoid using tampons, swimming, taking baths, or having sexual intercourse for three weeks.

Also, avoid any heavy lifting or strenuous exercise for one week. A health care provider will review your results with you within three weeks of the procedure. Please contact a health care provider if you haven’t heard from them. Usually, a follow-up appointment will be recommended six months after your LEEP.

Risks

 

There is a small possibility of heavy bleeding or an infection after a LEEP. Please contact a health care provider immediately if you notice any of the following: increased pelvic pain, heavy or prolonged bleeding, fever, or smelly vaginal discharge. 


Based on recent studies, your ability to get pregnant is not affected by a LEEP.  But there's a slight increase in the chance of pregnancy complications, such as miscarriage and delivering your baby before full term. Please speak with a health care provider to address any concerns. 


In rare cases, a LEEP may cause the entrance of your cervix to narrow, also known as cervical stenosis.

 
Please let the health care provider know if you’re pregnant. In many cases, the LEEP can be performed after your baby is born.

Your Follow-Up Appointment

 
Usually, you will have a follow-up colposcopy six months after your LEEP. The doctor will take a small tissue sample (biopsy) and will do a test to check for HPV. The HPV test will feel similar to a Pap test. 

The HPV test is used to determine if more follow-up is required, or if you can return to regular Pap test screening with a health care provider.

 
You are at very low risk having abnormal cell changes on the cervix if your biopsy and HPV test results are normal. You should continue to see your health care provider for cervical screening (Pap test).

 
A second LEEP is required if the biopsy taken at your follow up appointment shows high-grade cell changes of the cervix. You will continue to be monitored by the colposcopy clinic if you have an abnormal HPV test result but a normal biopsy result.
 

LEEP and HPV

 
LEEP may remove cells in your cervix containing human papillomavirus (HPV). In addition, HPV infections may be cleared by the body’s immune system. You will be tested for HPV after your LEEP.

Those with a normal HPV test after LEEP have a very low risk of having further high-grade cell changes (cervical intraepithelial neoplasia grade 2 or 3) in the near future. Those with an abnormal HPV test are at a higher risk of developing high-grade cell changes and closer follow-up is needed.

 

Yes, it is possible to get another HPV infection through sexual contact. 

 

Yes, even if you’ve already had treatment for cervical cancer or precancer, the HPV vaccine is still recommended. It will protect you from types of HPV you haven't been exposed to. Past HPV infections don't necessarily protect you from future infections even if it is the same type.

 

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