LEEP (Loop Electrosurgical Excision Procedure) is a treatment for cervical cancer. Your doctor will use a small wire loop (electrical) to go into your cervix and remove any abnormal cells they’ve discovered. These abnormal cells are typically discovered during a routine pap test, biopsy, or colposcopy.
How Does the Loop Electrosurgical Excision Procedure (LEEP) Work?
When you prepare to have LEEP, you will be asked to lay on the exam table much like you do when having a routine pap test. Your feet are supported in stirrups, and your doctor from All Women’s Care will insert a speculum into your vagina to open it. By opening your vagina with the speculum, the walls of your vagina are separated so the doctor can see inside to your cervix.
LEEP is used in treating moderate or mild precancerous changes in your uterus. This technique is sometimes used to treat cancers that have gone deeper into the tissue of your cervix or severe cases of dysplasia.
Once your physician can see into your cervix, they will use a numbing medicine and apply it to your vagina. Once you have been numbed, the doctor will use a small tool that has a wire loop (electrical wire) attached to remove any abnormal cells that have been discovered. A low voltage electric current is used to cut away the abnormal cells or tissue.
In some cases, your doctor will apply a local anesthetic medication in the area of the cervix, known as a cervical block. Medications for pain control can also be given intravenously or pre-operatively in pill form. This procedure is different from the ones where the abnormal tissue is destroyed, such as with freezing or laser techniques.
Once the cells have been removed, the blood vessels in the area they were removed from will be sealed to prevent bleeding. In some cases, your doctor from All Women’s Care may use a special paste to prevent you from bleeding after the removal of abnormal cells.
The abnormal cells collected from inside your cervix are preserved and will be sent to a lab for testing by a pathologist. The complete procedure should take approximately ten minutes. Your doctor will discuss the results with you once the lab has filed their report.
A speculum is a metal or plastic instrument used by gynecologists to separate the walls of the vagina and enable them to see the cervix and vagina
The vagina is your stretchy passage that connects the cervix, vulva, and uterus. This area is where menstruation comes out of your body, as well as a baby through childbirth. This area is also where you place sexual penetration with a finger, penis, or sex toy. During a woman’s menstruation cycle, it is where menstrual cups or tampons are placed.
The cervix is the lower, narrow portion of the uterus which has a small opening to connect your uterus to your vagina
- Pap test
Pap tests are performed to determine if there are abnormal cell changes in your cervix. The frequency in which these tests should be done depends on your age, medical history, and results of any previous tests. Your doctor at All Women’s Care will discuss how frequently you should schedule your individual tests.
A colposcopy is a test for cervical cancer. It allows your doctor to get a close-up look at your cervix to determine if there are any abnormal cells present.
A biopsy is when your doctor removes a small sample of tissue to have it further tested in a lab to make a diagnosis of a condition
Is the LEEP Painful?
During a LEEP, there may be some mild discomfort or cramping. With the numbing medication applied, you will not feel any heat from the loop or any of the cutting sensation. Most patients have reported they did not feel any sensations during the procedure.
Is There Preparation for LEEP?
LEEP is scheduled by your doctor at All Women’s Care after there has been a diagnosis of precancerous changes in your cervix. This diagnosis would follow a screening test and cervical biopsies. The finding of your Pap Test generally signals that further examination of the cervix is needed.
Colposcopy would be the necessary examination of your vaginal walls, vulva, and uterine cervix. This procedure uses illumination and magnification to check and examine abnormalities of these structures. Colposcopy is generally recommended to evaluate Pap tests with abnormal results. During this procedure, more testing, including a biopsy, is done to determine whether or not the abnormal cells or tissue are cancer or precancerous. If it is determined it is dysplasia, then your doctor at All Women’s Care will discuss the option of LEEP.
- What does precancerous mean?
A precancerous condition refers to a lesion involving abnormal cells. These cells are associated with an increased risk of developing cancer. They are often referred to as ‘precancerous’ as cancer has not yet progressed to an invasive or aggressive stage.
Sometimes these cells can progress to cancer, but most often, they do not. The cells can stay the same, remain abnormal, but not invasive, or they can even become healthy again. If the precancerous cells are removed before they can become cancerous, your condition is theoretically one-hundred percent curable.
- What is dysplasia?
Dysplasia is defined as the presence of cells, which are considered abnormal within your tissue. This condition can signify a stage preceding cancer or the development of cancer. It does not mean you will develop cancer if these cells are discovered, but you are at a higher risk of developing cancer than a person without this condition.
Before having your LEEP, do not take any medications that contain aspirin or aspirin itself for seven days before your scheduled appointment for the LEEP. You should drink and eat as you usually would, and there is no need to change your diet on the day of your appointment. You should have LEEP scheduled one week after your menstrual cycle, as this will help the doctor know the difference between bleeding caused by the procedure and the bleeding from your period.
If you think there is any chance you could be pregnant, you should discuss this with your doctor at All Women’s Care before the procedure is done.
What to Expect During LEEP
If you are scheduled to have LEEP, it may help to understand what you will experience during your treatment.
- Females between the ages of eleven and fifty will be asked to take a urine or pregnancy test prior to the start of the LEEP
- A patient care technician or nurse will show you the equipment to be used during your treatment if you are interested in seeing these items
- If you have any questions before beginning the procedure, your doctor at All Women’s Care will sit with you and answer any questions
- A technician or nurse will help you get into position, which is the same as when you have a Pap test. The procedure does use electricity, so there will be a grounding pad placed on your thigh. This pad will prevent you from getting shocked and protect you from getting hurt
- The doctor will begin by numbing your cervix with an injection of a numbing medication called lidocaine. There may be slight pressure and a mild burning as it is injected. This medication has been known to cause a patient's heart to beat a little faster.
- When the LEEP equipment is turned on, it will make a noise that sounds much like a vacuum.
- Once the medication has numbed your cervix, the doctor will pass the thin wire loop through the surface of the cervix and remove any abnormal cells discovered during your Pap test. There are times a second pass will be required to get all of the abnormal cells.
- Once the cells are removed, your doctor will cauterize the area from where they were taken to stop and prevent bleeding
- There will be a special solution applied by your doctor to your cervix to prevent future bleeding as well
- The equipment will be removed, and you will be placed in a comfortable position to rest for about ten to fifteen minutes
What to Expect After a LEEP?
Side effects after a procedure are mild pain, and there can be some cramping, which occurs over the first few hours after the treatment. Spotting and vaginal discharge can also appear and persist for up to several weeks. Tampons and sexual intercourse should be avoided to allow for more effective healing. You should also avoid douching and follow these precautions:
- Rest for the remainder of the day after your treatment is complete. You can return to work or school one to two days after LEEP
- If you experience any type of discomfort, you can take ibuprofen or Tylenol
- You are allowed to take a shower, but do not take a bath until your doctor at All Women’s Care says it is safe
- You may notice a brownish discharge for one to two days after LEEP. This discharge is from the solution put on your cervix to prevent bleeding. You can use a sanitary pad to catch this discharge
- There may be vaginal bleeding that resembles menstrual flow from one to four days after your treatment. There may be more bleeding ten to twelve days later as you begin to heal. The amount of bleeding or discharge varies for every woman
- You should not perform any strenuous activity such as aerobics or running for about one week after the treatment
- It is normal to have a heavy or late menstrual cycle following LEEP
- Should you experience a temperature spike of more than 101 Fahrenheit, chills, blood clots or heavy vaginal bleeding, or pain that cannot be controlled with over-the-counter medications, you should contact your doctor at All Women’s Care
It can take the lab several days to analyze the sample taken and provide a report to your doctor.
Are There Complications or Risks with LEEP?
There are no reported or common risks with LEEP. Any complications or side effects would involve increased bleeding, narrowing of the cervix opening, or infection. LEEP is associated with preterm labor in a subsequent pregnancy, and your doctor may want to schedule a followup in this situation.
LEEP carries a small risk of making your cervix ‘incompetent’ during pregnancy. This incompetence means your cervix does not stay closed tightly enough during pregnancy. If this issue should occur, there are procedures to help keep the cervix closed, so it is able to support a pregnancy.
LEEP has been presented as ‘very safe,’ but there are some risks acknowledged. Some risks include a heightened risk of premature labor, low birth weights, second-trimester miscarriage, and in few, rare cases there have been reports of the cervix narrowing, which caused the menstruation cycle to be obstructed causing severe pain.
Other complaints have come through from a group of women complaining that the LEEP procedure has affected their sexual drive. The official word from most doctors in the United States, and worldwide, is there are no proven sexual side effects from the LEEP procedure. While there has not been a lot of research into the side effects of sexual drive impact, one paper in Thailand found that LEEP is associated with a small but significant decrease in overall sexual satisfaction.
If you have concerns with side effects from LEEP, talk to your doctor at All Women’s Care to find the latest information regarding the safe and effective use of this procedure to prevent the risk of developing cancer.
Are There Follow Up Requirements After LEEP?
If your doctor at All Women’s Care has been able to remove the abnormal area successfully, there is no need for follow-ups. If, however, dysplasia is diagnosed, it can recur at a later time. Regular Pap tests would be required following LEEP to evaluate possible recurrence.
Prognosis for Cervical Dysplasia After LEEP
LEEP has proven to be an effective treatment for cervical dysplasia, just as laser, cone biopsy, or cryocautery. All of these treatments are showing to have more than a ninety percent survival rate for lesions that are precancerous of the uterine cervix.
- What is Laser Treatment for Precancerous?
Laser therapy or laser ablation is a treatment that will destroy abnormal cervical cells. These abnormal cells are destroyed to allow healthy cells to grow back in their place. This procedure is performed in a hospital or outpatient clinic with a local anesthetic.
- What is Cone Biopsy?
Cone biopsy is a more extensive form of cervical biopsy and received its name from the cone-shaped wedge of tissue that is removed from your cervix. This tissue sample is sent to the lab and studied under a microscope. The tissue taken during a cone biopsy is abnormal and located high in the cervical canal.
- What is Cryocautery?
Cryocautery is a treatment using liquid nitrogen (freezing gas) to destroy precancerous cells on the cervix. Once these precancerous cells are removed, your body can replace them with healthy, new cells.
Cryocautery involves freezing your cervix with a metal probe. The probe is used from one to two minutes to complete the freeze. This procedure can also be used to treat mildly abnormal cells on the cervix.
Cryocautery or freezing of the cancerous cells is performed under a procedure called cryotherapy. The treatment is applied much like LEEP as you lie down on the exam table, and the doctor inserts a speculum to open the walls of your vagina.
A tool called a cryoprobe is used to hold your cervix for a few minutes gently, and it will freeze your cells quickly. This procedure is typically repeated twice with a few minutes rest in-between applications. The whole process should last about five minutes.
Cryotherapy has about a ninety percent success rate for curing abnormal cells, so the problem doesn’t return. If the treatment doesn’t remove all the abnormal cells, your doctor at All Women’s Care may suggest you repeat the procedure, or they may instead suggest you have an alternative treatment, LEEP.
LEEP and HPV (Human Papillomavirus)
Human papillomavirus (HPV) is a virus that is spread through sexual contact. This virus will invade your cells in your vagina and cervix and can be cleared in most women without any special treatment, as in many cases, the infected cells are shed from the vagina and cervix. In some cases, however, the virus does not clear and persists in some of the cells of the cervix. If HPV persists in the cervix, it can change in appearance when viewed under a microscope and can cause cervical cancer.
There is no treatment to eliminate or cure the virus once it has infected your body’s system. There is an HPV vaccine that has been recently approved by the FDA that is able to prevent infection and is for women who have never been infected. The vaccine has to be given before a person becomes sexually active. LEEP is able to get rid of abnormal cells that are caused by HPV, but it does not get rid of the actual HPV virus infection.
Your doctor at All Women’s Care would recommend a LEEP if you were infected by HPV through sexual activity, and the HPV persisted and caused abnormal changes in the cells of your cervix. If these abnormal cells were detected through your Pap test, you would then most likely have been scheduled for a colposcopy and a biopsy of your cervix.
If the biopsy then showed abnormal cells that suggested to your doctor there was cancer present or showed cervical cancer cells that were not invading deeper tissue of your cervix; the doctor would want to get rid of those cells. To get rid of the abnormal cells, your doctor at All Women’s Care may suggest LEEP.
- What is HPV?
The human papillomavirus (HPV) is the most common sexually transmitted infection, with almost fourteen million new cases diagnosed each year in the U.S. There are different forms of this infection, and some can cause genital warts, while others are responsible for cancers.
Some of the key points regarding this infection include:
- Most sexually active women and men will contract HPV at some point in their life
- HPV can be spread through anal, vaginal, or oral sex
- HPV can be transmitted during childbirth causing a newborn to experience respiratory infections
- There is no known cure for HPV, but there are effective, safe vaccines to prevent it
While there is no cure for this virus, the symptoms resulting from it can be treated. Genital warts, one of the results of this infection can be treated with medication to remove the warts. A chemical, podophyllin, which your doctor can apply, will remove the warts in some cases. There is also Imiquimod, Podofilox, or Trichloroacetic acid, which your doctor may also try for removal. If these chemicals do not work, some cases may require Cryotherapy, electrocautery, laser therapy, interferon injection, or LEEP to remove the warts.
Other types of HPV can increase the risk of developing cancer, including cancer of the anus, penis, vulva, vagina, oropharynx, or cervix. It may take years for these to develop.
HPV is passed skin-to-skin through sexual intercourse or through other types of contact with the genitals. Because there is no cure for this infection, your best protection is prevention. To reduce the risk of contracting HPV, you should:
- Receive the HPV vaccine
- Use safe sex measures
- If warts are present, do not have sexual contacts
Why Gynecology is so Important
Prevention and early detection are the keys to a successful outcome if you have developed any health-related issues with your female reproductive system. Talk with your doctor at All Women’s Care about scheduling annual checkups and how procedures such as LEEP can help you maintain your health.
Who Can Perform LEEP Near Me?
If you have had an abnormal Pap test and want to learn more about how LEEP can benefit you, call All Women’s Care at 213-250-9461. We can provide you with state-of-art health care for all your medical needs. At All Women’s Care, we can offer you the highest standard of care and provide you with all the information you need to make the best medical decision for your care and treatment.