Loop Electrosurgical Excision Procedure (LEEP)

Loop electrosurgical excision procedure (LEEP) uses a wire loop heated by electric current to remove cells and tissue as part of the diagnosis and treatment for abnormal or cancerous cells on your cervix.

With LEEP, an electric current passes through the fine wire loop removing the abnormal precancerous or cancerous tissue. This tissue will then be sent to the lab for examination.

LEEP may also be used to assist in the diagnosis or treatment of the following conditions:

  • Polyps (benign growths)
  • Genital warts, which may indicate infection with human papilloma virus (HPV), a risk factor for developing cervical cancer.

Risks of LEEP

As with any surgical procedure, complications may occur. Some possible complications may include, but are not limited to, the following:

  • Infection
  • Bleeding
  • Changes or scarring in the cervix from removal of tissue
  • Difficulty getting pregnant
  • Potential for preterm birth or having a low birth weight baby

If you are allergic to or sensitive to medications, iodine, or latex you should notify us before having a LEEP procedure.

You should also notify us before having a LEEP if you are pregnant or suspect that you may be pregnant.

There may be other risks depending on your specific medical condition. Be sure to discuss any concerns with us prior to the procedure.

Certain factors or conditions may interfere with LEEP. These factors include, but are not limited to the following:

  • Menstruation
  • Acute pelvic inflammatory disease
  • Acute inflammation of the cervix

Before the LEEP

  • We will explain the procedure to you and offer you the opportunity to ask any questions that you might have about the procedure.
  • You will be asked to sign a consent form that gives your permission to do the procedure. Read the form carefully and ask questions if something is not clear.
  • Generally, no prior preparation, such as fasting or sedation, is required. If you will need to have the procedure done under general anesthesia at the hospital or surgery center, you will need to fast for 8 hours before (nothing by mouth, even gum).
  • If you are pregnant or suspect that you are pregnant, you should notify us before your procedure.
  • Notify us if you are sensitive to or are allergic to any medications, latex, tape, iodine, and anesthetic agents (local and general).
  • Notify us of all medications (prescribed and over-the-counter) and herbal supplements that you are taking.
  • Notify us if you have a history of bleeding disorders or if you are taking any anticoagulant (blood-thinning) medications, aspirin, or other medications that affect blood clotting. It may be necessary for you to stop these medications prior to the procedure.
  • Do not douche, or use any vaginal creams for 48 hours prior to your procedure.
  • Take Ibuprofen 600mg by mouth the night before your procedure. If you are sensitive to Ibuprofen do not take.
  • You may want to bring a sanitary napkin to wear home after the procedure.

During the LEEP

img-018

LEEP may be performed in a health care provider’s office, on an outpatient basis, or as part of your stay in a hospital. Procedures may vary depending on your condition and your health care provider’s practices.

Generally, LEEP follows this process:

  • You will be asked to undress completely or from the waist down and put on a drape or gown.
  • You will be instructed to empty your bladder prior to the procedure.
  • You will lie on an examination table, with your feet and legs supported as for a pelvic examination.
  • Your health care provider will insert an instrument called a speculum into your vagina to gently spread the walls of the vagina apart to expose the cervix.
  • Often, the health care provider will use a colposcope, an instrument with a special lens similar to a microscope, to magnify the tissues. The colposcope will be placed at the opening of your vagina but does not enter your vagina.
  • Your health care provider will look through the colposcope to locate any areas for treatment on the cervix or in the vagina. Images of the areas on your cervix may be made for your health care record.
  • Your cervix may be cleansed and soaked with a vinegar solution, also called acetic acid solution. This helps make the abnormal tissues turn white and become more visible. You may feel a mild burning sensation. An iodine solution is sometimes used to coat the cervix, called the Schiller test.
  • Your health care provider will numb the area using a small needle to inject medication.
  • A type of forceps, called a tenaculum, may be used to hold the cervix steady for the procedure. You may feel a little discomfort and some cramping when the tenaculum is applied.
  • You will hear humming and/or blowing sounds from the equipment.
  • The LEEP wire will be inserted through the speculum and passed through the abnormal tissues. One or more passes may be needed. You may feel pressure or a slight cramping.
  • Some women feel faint during the procedure. Tell your health care provider or the nurse if you have this feeling.
  • It is very important that you lie still during the procedure.
  • The electrical current will act as a cautery to seal the blood vessels, so usually there is very little bleeding. Any bleeding from the LEEP site may be treated with a paste-like topical medication. It is important to wear a pad or liner after the procedure until the bleeding and discharge stops, since the medication will stain your clothes. When the medicine comes out it may be clumpy and tissue like, which is normal.
  • The tissue will be sent to a lab for further examination.

After the LEEP

After LEEP, you may rest for a few minutes after the procedure before going home.

You may want to wear a sanitary pad for bleeding. It is normal to have some mild cramping, spotting, and dark or black-colored discharge for several days. The dark discharge is from the medication applied to your cervix to control bleeding. Remember to wear a pad or liner until it stops coming out, since it will stain your clothes.

You should not douche, use tampons, or have intercourse for four weeks after LEEP.

You will need someone to drive you home. You may drive the following day unless you are taking pain medication.

Take a pain reliever for cramping or soreness as prescribed. Aspirin or certain other pain medications may increase the chance of bleeding. Be sure to take only recommended medications.

You will need to follow up 1-2 weeks after your procedure and 6 months after for a follow up pap unless otherwise instructed.

Notify us (509) 628-8866 if you have any of the following:

  • Heavy bleeding with clots. (Bleeding heavier than you heaviest period)
  • Foul-smelling drainage from your vagina
  • Fever and/or chills
  • Severe abdominal pain

Your health care provider may give you additional or alternate instructions after the procedure, depending on your particular situation.