LEEP

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What is a LEEP?
Woman talking to doctor

LEEP stands for loop electrosurgical excision procedure. It is a procedure to remove precancerous or abnormal cells from the cervix. The cervix is the neck-shaped opening at the lower, narrow part of the uterus. It connects the uterus to the vagina. LEEP involves using a thin wire loop heated by electric current to shave off a thin layer of cervical tissue. Doctors use LEEP to treat cervical dysplasia (precancerous cells on the cervix) and diagnose the cause of moderate to severe cell abnormalities. 

Your doctor may recommend a LEEP after other gynecologic screening tests detect abnormal cervical cells. LEEP may be the only treatment necessary to cure your condition. In other cases, LEEP results can help guide other treatment.

LEEP is only one method used to treat cervical abnormalities. Discuss all your treatment options with your doctor to understand which options are right for you.

Why is a LEEP performed?

Your doctor may recommend a LEEP to diagnose or treat diseases and conditions of the cervix including:

  • Abnormalities that show up on other gynecologic screening tests such as a Pap test, colposcopy, or cervical biopsy

  • Diethylstilbestrol (DES) exposure

  • Genital warts, a sign human papillomavirus (HPV) infection

  • Polyps, which are benign growths

Who performs a LEEP?

A gynecologist performs LEEP. A gynecologist is a doctor who specializes in women’s reproductive health.

How is a LEEP performed?

Your doctor will perform a LEEP in a doctor’s office or outpatient setting. The procedure takes about 10 minutes and generally includes these steps: 

  1. You will undress from the waist down and use a paper covering for modesty, or undress completely and put on a hospital gown.

  2. You will lie on an examination table and rest your feet in stirrups.

  3. Your doctor will gently insert a speculum into your vagina to view and access the cervix.

  4. Your doctor may use a colposcope (a special magnifying glass) to examine the cervix and find the abnormal areas.

  5. Your doctor will inject local anesthetic into the cervix to numb it.

  6. Your doctor may apply a vinegar solution to the cervix to make the abnormal tissue more visible.

  7. Your doctor will pass the wire loop through the cervix to remove the abnormal tissue. The wire loop is heated with an electric current, which helps control bleeding. Your doctor may use forceps to hold the cervix still during this part of the procedure.

  8. If necessary, your doctor will apply a special paste to your cervix to stop bleeding.

  9. A lab will examine the tissue samples.

Will I feel pain?

Your comfort and relaxation is important to both you and your care team. You may feel pressure or cramping during the procedure, but you should not feel pain. Tell your doctor is you are uncomfortable or feel faint during the procedure.

What can I expect after my LEEP?

Knowing what to expect after a LEEP can help you get back to your everyday life as soon as possible. 

How will I feel after a LEEP?

You might feel drowsy if you had sedative medications. You may have mild cramping, spotting, and brownish-black discharge for several days and up to a week following LEEP. It may take up to four weeks for your cervix to heal. Follow your doctor’s advice for recovery. General recovery tips include:

  • Avoid heavy lifting and strenuous activity

  • Don’t put anything in the vagina for at least four weeks (avoid douching, sex and tampons)

  • Don’t swim or soak in a tub

  • Take pain medications only as your doctor recommends. Some pain medicines, such as aspirin, increase the risk of bleeding.

When can I go home?

You should be able to go home right after the procedure. If you had sedative medications, you will need a family member or friend drive you home.

When should I call my doctor? 

It is important to keep your follow-up appointment after a LEEP. Call your doctor for questions and concerns between appointments. Call your doctor right away or seek immediate medical care if you have: 

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2018 Nov 4
  1. Loop Electrosurgical Excision Procedure. John Hopkins Medicine. http://www.hopkinsmedicine.org/healthlibrary/test_procedures/gynecology/loop_electrosurgical_excisio...
  2. How are cervical cancers and pre-cancers diagnosed? American Cancer Society. http://www.cancer.org/cancer/cervicalcancer/detailedguide/cervical-cancer-diagnosis
  3. Loop Electrocautery Excision Procedure (LEEP) and Cone Biopsy. University of Washington. http://www.uwmedicine.org/patient-care/our-services/medical-services/gynecology/pages/articleview.as...
  4. Colposcopy. American College of Obstetricians and Gynecologists. http://www.acog.org/~/media/For%20Patients/faq135.pdf?dmc=1&ts=20130830T1246282949
  5. LEEP: Post-Procedure Restrictions. Better Medicine. http://www.bettermedicine.com/article/leep-post-procedure-restrictions
  6. FAQ: Loop Electrosurgical Excision Procedure. The American Society of Obstetricians and Gynecologists. http://www.acog.org/~/media/For%20Patients/faq110.pdf?dmc=1&ts=20130910T1614243327
  7. Understanding Cervical Changes: A Health Guide for Women. National Cancer Institute. http://www.cancer.gov/cancertopics/understandingcervicalchanges/page12
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