The loop electrosurgical excision procedure (LEEP) is a way to remove abnormal tissue from the cervix. It is done using a fine wire loop that has a low-voltage electrical current. LEEP may be done after colposcopy and cervical biopsy have confirmed an abnormal Pap test result. In some cases, LEEP may be done instead of a cone biopsy.
During LEEP, you will lie on your back with your feet supported by stirrups. Your doctor will use a speculum to gently spread apart the vaginal walls. This lets the doctor check the inside of your vagina and your cervix. Medicine will be used to numb the cervix. You may also be given pain medicine as a pill or into a vein (IV). Then the doctor will use a wire loop to cut a thin layer of abnormal tissue from the cervix.
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.
What To Expect After Surgery
You will be able to return to most of your normal activities in 1 to 3 days.
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.
You will need to avoid sexual intercourse, tampons, and douching for about 3 weeks.
Call your doctor right away if you have problems after surgery, such as:
- Severe vaginal bleeding. This means soaking through a pad each hour for 2 or more hours.
- Pain that does not get better after you take pain medicine.
- Signs of infection. These include increasing pain, vaginal discharge that smells bad, and fever.
Why It Is Done
LEEP may be used to treat cell changes on the cervix.
LEEP can also help to diagnose abnormal cells. The tissue that is removed during LEEP can be checked for abnormal cell changes or cancer.
How Well It Works
LEEP works very well to treat abnormal cell changes on the cervix.
If all of the abnormal tissue is removed, you will not need more surgery. In some studies, doctors were able to remove all the abnormal cells in almost every case. But abnormal cells may come back in the future.
Most women do not have problems after LEEP. If a woman gets pregnant after having LEEP, she may be more likely to deliver her baby early.
Rare problems include infection of the cervix or uterus and narrowing of the cervix that might make it hard to get pregnant.
What To Think About
LEEP works as well as other treatments for abnormal cervical cells. These treatments include cone biopsy, freezing the abnormal cells (cryotherapy), and using a laser to destroy or remove them. LEEP is easier to do than cone biopsy or carbon dioxide laser treatment.
If you have LEEP, you will need to have a Pap test every 4 to 6 months or as often as your doctor says. After your results are normal a few times, you and your doctor can decide how often to schedule future Pap tests.
Other Works Consulted
Garcia F, et al. (2012). Intraepithelial diseases of the cervix, vagina, and vulva. In JS Berek, ed., Berek and Novak's Gynecology, 15th ed., pp. 574-618. Philadelphia: Lippincott Williams and Wilkins.
Samson SA, et al. (2005). The effect of loop electrosurgical excision procedure on future pregnancy outcomes. Obstetrics and Gynecology, 105(2): 325-332.
Primary Medical ReviewerSarah Marshall, MD - Family Medicine
Kathleen Romito, MD - Family Medicine
Adam Husney, MD - Family Medicine
Specialist Medical ReviewerKirtly Jones, MD - Obstetrics and Gynecology
Current as ofJuly 10, 2015