What is Loop Electrosurgical Excision Procedure

Loop electrosurgical excision procedure (LEEP) is the cutting and removal (excision) of part of the cervix. The cervix is the bottom part of the uterus that opens into the vagina. The tissue that is removed from the cervix is then examined to see if there are precancerous cells or cancer cells present. LEEP may be done when:

• You have abnormal bleeding from your cervix.
• You have an abnormal Pap test result.
• Your health care provider finds an abnormality on your cervix during a pelvic exam.

LEEP typically only takes a few minutes and is often done in the health care provider’s office. The procedure is safe for women who are trying to get pregnant. However, the procedure is usually not done during a menstrual period or during pregnancy.

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have, including current or past vaginal infections, such as herpes or sexually transmitted infections (STIs).
• Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Infection.
• Bleeding.
• Allergic reactions to medicines.
• Changes or scarring in the cervix.
• Increased risk of early (preterm) labor in future pregnancies.

What happens before the procedure?

• Ask your health care provider about:
  • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines before your procedure if your health care provider instructs you not to.
• Your health care provider may recommend that you take pain medicine before the procedure.
• Plan to have someone take you home after the procedure.

What happens during the procedure?

• An instrument called a speculum will be placed in your vagina. This will allow your health care provider to see the cervix.
• You will be given a medicine to numb the area (local anesthetic). The medicine will be injected into your cervix and the surrounding area.
• A solution will be applied to your cervix. This solution will help the health care provider find the abnormal cells that need to be removed.
• A thin wire loop will be passed through your vagina. The wire will be used to burn (cauterize) the cervical tissue with an electrical current.
• The abnormal cervical tissue will be removed.
• Any open blood vessels will be cauterized to prevent bleeding.
• A paste may be applied to the cauterized area of your cervix to help prevent bleeding.
• The sample of cervical tissue will be examined under a microscope.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• You may have mild abdominal cramping.
• You may have a small amount of bleeding (spotting) from the vagina.
• You may have a dark-colored discharge coming from your vagina. This is from the paste that was used on the cervix to prevent bleeding.
• Your health care provider may recommend pelvic rest. Pelvic rest generally means avoiding sex and not putting anything in the vagina, such as tampons, creams, and douches.
• It is your responsibility to get your test results. Ask your health care provider or the department performing the test when your results will be ready.

Loop Electrosurgical Excision Procedure, Care After

Refer to this sheet in the next few weeks. These instructions provide you with information about caring for yourself after your procedure. Your health care provider may also give you more specific instructions. Your treatment has been planned according to current medical practices, but problems sometimes occur. Call your health care provider if you have any problems or questions after your procedure.

What can I expect after the procedure?

After the procedure, it is common to have:

• Abdominal cramps that are similar to menstrual cramps. These may last for up to 1 week.
• Pink-tinged or bloody vaginal discharge, including light to moderate bleeding, for 1–2 weeks.
• A dark-colored vaginal discharge. This is from the paste that was applied to your cervix to control bleeding.

Follow these instructions at home:

Activity

• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
• Avoid strenuous physical activity for as long as told by your health care provider.
• Do not lift anything that is heavier than 10 lb (4.5 kg) until your health care provider says that it is safe.

Bathing

• Do not take baths, swim, or use a hot tub until your health care provider approves.
• You may take showers.

Lifestyle

• Do not put anything in your vagina for 2 weeks after the procedure or until your health care provider says that it is okay. This includes tampons, creams, and douches.
• Do not have sexual intercourse until your health care provider approves.

General instructions

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• You have a fever or chills.
• You feel unusually weak.
• You have vaginal bleeding that is heavier or longer than a normal menstrual cycle. A sign of this can be soaking a pad with blood.
• You have severe pain.
• You have nausea or vomiting.
• You develop a bad smelling vaginal discharge.