What is loop electrosurgical excision procedure (LEEP)?
Loop electrosurgical excision procedure (LEEP) diagnoses and treats abnormal tissue on your cervix. Your cervix is a small opening that connects the uterus to the vagina.
During a gynecology visit your provider may have performed a Pap test or colposcopy. If the results were abnormal, it means that some cells in the cervical tissue look different than normal (cervical dysplasia). This abnormal tissue isn’t cancerous but could become cervical cancer if it isn’t removed.
Penn Medicine’s skilled providers use LEEP to remove the tissue from your cervix. We use advanced technology and minimally invasive techniques to help you feel less discomfort and recover quicker after the procedure.
After the LEEP procedure, our pathologists look at the tissue sample under the microscope to confirm whether abnormal cells are present.
Who is a candidate for LEEP?
Your provider may recommend LEEP if they find abnormal cells on your cervix during or after a:
- Colposcopy: Examination of your cervical tissue using a special, lighted magnifying instrument
- Biopsy: Removal of a small tissue sample from your cervix
- Pap test: Screening that tests cells taken from your cervix with a small brush
What to expect during a LEEP procedure
Your provider will explain each step of the loop electrosurgical excision procedure and answer your questions. We do LEEP when you’re not on your period, so we schedule the procedure to avoid that time in your cycle.
You’ll lay down so you’re comfortable and relaxed. Like a pelvic exam, your doctor opens your vagina with a tool called a speculum so they can get a clear view of your vagina and cervix.
Your provider numbs your cervix with local anesthesia to help minimize any pain or discomfort during the procedure. They may clean your cervix with a vinegar solution so they can see the abnormal tissue.
Your provider then inserts a loop of thin wire into your vagina. Electricity heats the wire, and your doctor uses it to remove the abnormal tissue on your cervix. You may feel some tingling and cramping in your abdomen while they remove the tissue.
Your provider puts a medicated paste on your cervix to stop any bleeding. This paste will turn black when it mixes with blood and may result in black discharge for several days following your procedure. This is normal.
After the procedure, you may experience a few side effects, such as mild cramping and moderate to heavy discharge. The discharge could last 1 to 2 weeks.
We send the cervical tissue to the lab, where a pathologist examines it under a microscope to confirm the abnormal cells. If the outer edges of the tissue still show abnormal cells, you may need an additional procedure to remove them.
LEEP recovery
The recovery time is different for every patient and depends on how much cervical tissue your doctor removed. Your doctor will let you know when you can return to normal activities. You should avoid vaginal intercourse or putting anything in your vagina until your provider says it’s okay.
You may need regular human papillomavirus (HPV) tests, Pap tests, and colposcopies. Your provider will tell you when to repeat these tests so we can catch any cervical changes early on when treatment is the most successful.
Loop electrosurgical excision procedure risks
Most people don’t have issues after LEEP. However, there are some risks, including:
- Bleeding that requires stitches or a transfusion
- Cervical narrowing that can impact your ability to become pregnant
- Increased risk of miscarriage or preterm delivery
- Infection
- Scarring
LEEP expertise at Penn Medicine
At Penn Medicine, we perform a high volume of LEEP procedures each year. This means our team provides excellent care supported by extensive experience.
If cervical cancer is detected, you receive seamless, coordinated care. We connect you with experts at the Jordan Center for Gynecologic Cancers, where you get outstanding, personalized treatment.
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