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Loop Electrosurgical Excision (LEEP)

What is LEEP? What are the Purposes of LEEP?

The Loop Electrosurgical Excision Procedure (LEEP) is used to diagnose and treat abnormalities of the uterine cervix. Cervical dysplasia occurs in a mild, moderate and severe form. The treatment options are individualized by each patient's age, risk factors and preference. The nature of this procedure is to surgically destroy or remove the abnormal areas, and to possibly send a piece of the tissue to the lab for analysis. The procedure is diagnostic, and usually therapeutic.

LEEP uses a thin wire loop that acts like a scalpel (surgical knife). An electric current is passed through the loop, which cuts away a thin layer of the cervix.

During the procedure, you will lie on your back and place your legs in stirrups. The doctor then will insert a speculum into your vagina in the same way as for a pelvic exam. Local anesthesia will be used to prevent pain. It is given through a needle attached to a syringe. You may feel a slight sting, them a dull ache or cramp. The loop is inserted into the vagina to the cervix. There are different sizes and shapes of loops that can be used. After the procedure, a special paste may be applied to your cervix to stop any bleeding. Electrocautery also may be used to control bleeding. The tissue that is removed will be studied in a lab to confirm the diagnosis.

What are the possible risks and complications from LEEP?

• Following the procedure, adverse effects may include feeling lightheaded, weak, nauseous or crampy.

• Incomplete resolution of the abnormality requiring a future procedure or additional follow-up testing

• Rarely, heavy bleeding may occur following the procedure necessitating return visit for treatment either in clinic or hospital.

• Preterm delivery if it is done during pregnancy

• Cervical Stenosis (narrowing of the cervical canal) and adhesion

• Blood loss, potentially necessitating transfusion

• Infection

• Complications from local anesthesia include headache, dizziness, increased pulse, increased respiration rate, or syncope (passing out)

• Recurrent, progress and further treatment

• Persistent HPV infection

Your Recovery

After the procedure, you may have

• a watery, pinkish discharge

• mild cramping

• a brownish-black discharge (from the paste used)

It will take a few weeks for your cervix to heal. While your cervix heals, you should not place anything in the vagina, such as tampons or douches. You should not have intercourse. Your health care professional will tell you when it is safe to do so.

Call us if you have any of these problems:

• Heavy vaginal bleeding (using more than one sanitary pad per hour)

• Severe lower abdominal pain

• Fever

• Chills