LEEP is an abbreviation for "loop electrosurgical excision procedure." It is also referred to as large loop excision of the transformation zone, or LLETZ. This is a procedure for treating cervical dysplasia. Cervical dysplasia (or cervical intraepithelial neoplasia) is abnormal tissue growth in the cervix. The cervix is the narrow, lower portion of the uterus. Cervical dysplasia is most frequently discovered from a Pap smear, a test which most women should have done every year. Several types of cervical dysplasia can progress to cervical cancer if not treated. In the LEEP procedure, a wire loop is used to remove the abnormal tissue from your cervix. This procedure allows a your health care provider to locate and remove the cervical dysplasia in one outpatient appointment. It saves the step of taking a sample piece of tissue (a biopsy) before removing the abnormal tissue with a laser or freezing it (which are other ways of treating cervical dysplasia).

What happens during the procedure?

This procedure is done when you are not having your menstrual period. It can be performed in the office if your doctor feels it is safe or can be done in the hospital as an outpatient procedure. Your legs are first put up in stirrups on the treatment table. Your health care provider then looks at your vagina and cervix through a colposcope, which is like a magnifying glass. Once your provider sees the area where the dysplasia is, he or she numbs that part of your cervix with a local anesthetic. Your provider then removes the abnormal tissue with a thin wire loop that is connected to an electrical unit. The loop is used to scoop out the abnormal tissue in one piece and to seal any bleeding blood vessels. A medicated paste is then put on the cervix to stop any bleeding. The only sensation you may feel is a slight tingling. The procedure takes only about 5 minutes. The tissue that has been removed is sent to the lab for testing.

What happens after the procedure?

You may have some minor bleeding or spotting the first day or so after the procedure. For 2 weeks after the procedure you will have a brownish discharge. This is a normal part of the healing of your cervix. Your cervix should be totally healed within a month. You should avoid heavy lifting, tampons, douching, and sexual intercourse for 4 weeks after the procedure. See your health care provider for follow-up visits and Pap smears as recommended.

What are the risks of this procedure?

Rarely the cervix may become infected. Infection can cause the opening in your cervix to become narrower. This narrowing might make it more difficult for you to get pregnant.

When should I call my health care provider?

Call your health care provider if:

You have any discharge from your vagina that has a bad odor.
You have a fever.
You have severe abdominal pain.
You have bleeding that lasts more than 1 week.

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Robert B. McWilliams, MD Reproductive Endocrinology and Gynecology

LEEP

Robert B. McWilliams, MD
Reproductive Endocrinology
and Gynecology