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Barbara L. Patrick MD, Facog Gynecology Services
mail clinic@womantowomangyn.com

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Loop Electrosurgical Excision Procedure

Your cervix is the lower, narrow end of your uterus. Cells on the cervix are constantly growing. Sometimes these cells change and grow abnormally. This may be an early warning that cancer may occur.

A Pap test detects changes in the cervix. Other tests, such as colposcopy and biopsy, are also used. When these tests show that you have abnormal cells on your cervix, your doctor may recommend the loop electrosurgical excision procedure (LEEP). LEEP is used to remove the abnormal cells from your cervix. 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 surface cells.

The Cervix

A thin layer of tissue like your skin covers the cervix. The cells that make up this tissue grow all the time. During this growth, the cells at the bottom layer slowly move to the surface of the cervix. When these cells reach the surface, they are shed as a normal process.

When this normal process is changed in some way, cells become abnormal. This condition is known as dysplasia. In mild forms, this condition may go away on it’s own. If it is severe or does not go away, it may lead to cervical cancer. Other factors such as smoking and being exposed to sexually transmissible diseases (STDs) also increase the risk of cancer of the cervix.

Treating Dysplasia

Abnormal cells can be removed with LEEP. This allows new healthy cells to grow. LEEP is just one way to treat dysplasia. Dysplasia can also be treated with other procedures such as cryosurgery, electrocautery, laser, or cone biopsy. The decision of which method to use depends on how much cervical tissue needs to be removed and where on the cervix the abnormal cells are located.

The LEEP Procedure

The procedure should be done when you’re not having your menstrual period. This allows a better view of the cervix. LEEP is usually done in a doctor’s office or in a clinic on an outpatient basis. It usually takes only a few minutes.

You may be giving a pain medication before the doctor begins. During the procedure you will lie on your back and place your legs in stirrups. The doctor will then insert a speculum into your vagina in the same way as for a pelvic exam.

A solution is then applied to your cervix to show the abnormal cells. Colposcopy will be used to magnify the cervix during the surgery.

Your cervix will be numbed with local anesthesia. It is given through a needle attached to a syringe. You will remain awake during the procedure and may feel a dull ache or cramp.

The loop is inserted through the vagina to the cervix. There are different sizes and shapes of loops that can be used. After the procedure, a medicated paste may be applied to your cervix to stop any bleeding.

The tissue that is removed will be examined in a laboratory. This tissue will be examined to confirm the diagnosis.

Possible Problems

Although problems seldom occur with LEEP, there can be some complications. You may feel faint during the procedure or have some bleeding. There is also a risk of infection after the procedure. These complications are rare and can be treated easily.

You should contact your doctor if you have any of the following:

-Heavy bleeding (more than your normal period)
-Bleeding with clots
-Severe abdominal pain
-Fever (more than 100.4 degrees F)
-Foul-smelling discharge

Your Recovery

It may take a few weeks for your cervix to heal. While your cervix heals, you may have:

-Vaginal bleeding (less than a normal menstrual flow)
-Mild cramping
-A brownish black discharge (from the medicated paste used)

It’s important to help your cervix heal. For a few weeks after the procedure, you should not have sexual intercourse or use tampons or douches. If you have any discomfort, your doctor may prescribe pain medication.

Staying Healthy

After the procedure, you will need to see your doctor regularly for follow-up appointments for the first two years . At these visits your doctor will check the health or your cervix. After 2 years of normal results, you may return to having exams once a year. If you have another abnormal Pap test, you may need more treatment.

By making a few lifestyle changes after the procedure, you can help protect the health of your cervix:

-Have regular gynecologic exams and Pap tests.
-Stop smoking: smoking increases your risk of cervical cancer.
-If you have more than one sexual partner, limit your number of partners and use condoms to reduce your risk of STDs.

Finally...

LEEP is an effective and simple way to treat dysplasia. The procedure can be done in only a few minutes, and your recovery time is usually brief.