LEEP: Purpose, Procedure, Side Effects, Recovery & Pregnancy

What is a LEEP (loop electrosurgical excision procedure)?

LEEP is a minor surgical procedure used to remove abnormal tissue from the cervix. It involves using a thin, electrically charged wire loop to excise a small section of cervical tissue, which is then examined to check for precancerous or cancerous cells.

The procedure is primarily used to treat cervical dysplasia, a condition characterised by abnormal cell changes in the cervix. These changes are often caused by certain types of human papillomavirus (HPV) and can potentially develop into cervical cancer if left untreated.

Why is LEEP performed?

LEEP may be recommended by your doctor if you’ve ever had abnormal results from cervical screening tests, such as:

• Pap smear showing atypical squamous cells (ASC), low-grade squamous intraepithelial lesions (LSIL), or high-grade squamous intraepithelial lesions (HSIL)

• Colposcopy revealing areas of concern on the cervix

• Persistent infection with high-risk types of HPV

Preparing for LEEP

If you're scheduled for a LEEP, your doctor will give you specific instructions. Generally, you should:

• Schedule the procedure when you're not menstruating, preferably in the first half of your menstrual cycle.

• Avoid sexual intercourse, douching, or using tampons for a few days before the procedure.

• Inform your doctor about any medications you're taking, including over-the-counter drugs and supplements.

• Discuss any allergies or medical conditions you have.

• Arrange for someone to drive you home after the procedure, as you may feel uncomfortable.

For further information on how to prepare for LEEP, you may book an appointment with Thomson Medical Concierge. Our staff will help you with scheduling an appointment with an available specialist.

LEEP procedure

LEEP is typically performed as an outpatient procedure and usually takes about 10 to 20 minutes. Here's what you can expect:

1. Pre-procedure preparation

   • During the pre-procedure preparation, you would be positioned on an examination table, similar to having a pap smear.

   • A speculum will be inserted to open the vagina and allow clear access to the cervix.

2. Anaesthesia application

   • Local anaesthesia will be applied to numb your cervix. You may feel a slight pinch or burning sensation during this step.

3. Cervical examination

   • Your doctor will use a colposcope (a special magnifying instrument) to examine your cervix closely.

4. Tissue removal

   • The loop electrode will be carefully guided to remove the abnormal tissue. You might feel some pressure or mild cramping, but it shouldn't be painful.

5. Hemostasis

   • After removing the tissue, your doctor may apply a special paste to prevent bleeding.

6. Discharge after LEEP procedure

   • After the procedure, you will be monitored for a short period. Most patients can return home on the same day as the procedure.

LEEP recovery and follow-up care

Your doctor will schedule a follow-up appointment, typically within 2-4 weeks after the procedure. This visit allows your doctor to check your healing progress and discuss the results of your tissue analysis.

After the LEEP procedure, you may experience mild cramping for a few days, light bleeding or spotting for up to a few weeks and discharge from the paste used to control bleeding. Here are some tips to help mitigate potential discomfort in order to support your recovery:

1. Rest regularly

   • Attempt to rest for the remainder of the day after your procedure has been completed.

2. Utilise sanitary pads

   • Instead of tampons, opt for sanitary pads for post-procedure bleeding.

3. Avoid sexual activity

   • Ensure that you avoid sexual intercourse, douching, and strenuous activities for about 4 weeks.

4. Pain medication

   • If you feel discomfort, you may take over-the-counter pain relievers or be prescribed pain medication if necessary. 

   • If necessary, take over-the-counter pain relievers if needed for discomfort.

At Thomson Medical, we have a team of gynaecologists who specialise in performing LEEP and other cervical procedures. Our doctors are dedicated to providing thorough care in diagnosing and treating cervical abnormalities.

For more information about LEEP or to arrange a consultation with a gynaecologist, you may book an appointment with Thomson Medical Concierge. Our staff will help you with scheduling an appointment with an available specialist.

LEEP potential risks and complications

While LEEP is generally safe, like any medical procedure, it carries some risks. These may include:

1. Infection

2. Heavy bleeding

3. Cervical stenosis 

   • Otherwise known as narrowing of the cervix

4. Preterm labour

   • Slightly increased risk of preterm labour in future pregnancies

It's important to contact your healthcare provider if you experience severe pain, heavy bleeding, fever, or discharge after the procedure.

Long-term side effects of LEEP procedure

While LEEP is generally considered a safe and effective procedure, it's important to be aware of potential long-term side effects:

1. Cervical stenosis: 

   • In rare cases, LEEP may cause narrowing of the cervix, which could lead to fertility issues or difficulties during labour.

2. Increased risk of preterm birth

   • Some studies suggest a slightly increased risk of preterm birth in future pregnancies, particularly if multiple LEEP procedures are performed.

3. Cervical incompetence:

   • In very rare instances, LEEP may weaken the cervix, potentially leading to cervical incompetence during pregnancy.

4. Changes in cervical mucus

   • Some women report changes in the amount or consistency of cervical mucus following LEEP.

5. Persistent HPV infection:

   • While LEEP removes abnormal cells, it may not eliminate the underlying HPV infection.

It's important to discuss these potential long-term effects with your doctor before undergoing the procedure. Regular follow-up appointments are crucial to monitor your cervical health post-LEEP. 

If you have concerns about the long-term effects of LEEP, book an appointment with our specialists at Thomson Medical for personalised advice and care.

Disclaimer: The information provided is for general knowledge only and should not be considered a substitute for professional medical advice. If you're experiencing any of these symptoms, request an appointment with our specialists at Thomson Medical for an accurate diagnosis and tailored treatment plan.

FAQ

Is LEEP painful?

While the idea of the procedure might seem daunting, most women experience only mild discomfort. The local anaesthesia ensures you shouldn't feel sharp pain. You might feel some pressure or mild cramping during the procedure.

Does LEEP remove all HPV?

LEEP does not remove all HPV from your body. The procedure removes abnormal cervical tissue that contains HPV-infected cells, but it doesn't eliminate the virus from your entire system. HPV can remain dormant in other cells.

What are the benefits of LEEP?

LEEP is highly effective in removing precancerous cells and preventing the progression of cervical cancer while being quick and minimally invasive. LEEP provides valuable tissue samples for pathology, aiding in the diagnosis of cervical lesions or further treatment decisions.

Will LEEP affect my fertility?

LEEP generally doesn't affect fertility. However, in rare cases, it may slightly increase the risk of preterm birth in future pregnancies. If you're planning to have children, discuss this with your doctor before the procedure.

When should I seek medical attention after LEEP?

Contact your doctor immediately if you experience heavy bleeding (soaking through a pad in an hour), severe abdominal pain or a fever over 38°C. 

What happens when the scab falls off after LEEP?

When the scab falls off after a LEEP procedure, it's typically a sign of healing, usually occurring within 2-4 weeks after the procedure.

You may notice some spotting or light bleeding when this happens, which is normal. However, if you experience heavy bleeding or severe pain, contact your healthcare provider immediately.

Is a LEEP the same as a biopsy?

While both procedures involve removing cervical tissue, they are not the same. A biopsy typically removes a small sample of tissue for diagnostic purposes.

LEEP, on the other hand, removes a larger area of abnormal tissue and serves both diagnostic and treatment purposes. 

Cone biopsy vs leep: Which is more effective?

Both cone biopsy and LEEP are effective procedures for removing abnormal cervical tissue. The choice between the two depends on various factors, including the size and location of the abnormal area, the severity of the cell changes, and your doctor's preference. 

LEEP is often preferred for smaller lesions as it's less invasive, while cone biopsy might be chosen for larger lesions or when there's concern about invasive cancer.

Does the cervix grow back after LEEP?

The cervix doesn't "grow back" in the traditional sense after LEEP. However, the area where the tissue was removed will heal over time. New, healthy tissue will cover the treated area, but the cervix may be slightly smaller or shaped differently than before the procedure.

What happens if LEEP is unsuccessful?

If a LEEP procedure is unsuccessful in removing all abnormal cells, your doctor may recommend additional treatments. These could include another LEEP, a cone biopsy, or in some cases, more extensive surgery.

Does your period change after LEEP?

Some women may experience temporary changes in their menstrual cycle after LEEP, such as lighter or heavier periods, or slight changes in timing.

These changes are usually temporary and resolved within a few months. If you experience persistent, significant changes in your menstrual cycle after LEEP, consult your healthcare provider.