LEEP or LLETZ
What it is
The loop electrosurgical excision procedure (LEEP) uses a thin, low-voltage electrified wire loop to remove abnormal tissue. LEEP is also known as large loop excision of the transformation zone (LLETZ).
Why it is done
LEEP is done after abnormal Pap test results have been confirmed by colposcopy and cervical biopsy. This method may be used to treat cell changes on the cervix such as:
LEEP is commonly used to:
A vinegar (acetic acid) or iodine solution (which makes abnormal cells more visible) may be applied to the cervix before the procedure is performed.
How it is done
LEEP is usually done at your doctor's office, a clinic or other medical facility as an outpatient procedure. You do not have to spend the night in a hospital.
You will need to take off your clothes below the waist and drape a paper or cloth covering around your waist. You'll lie on your back on an exam table with your feet raised and supported by stirrups. Your doctor will insert a lubricated tool called a speculum into your vagina. The speculum gently spreads apart the vaginal walls, allowing the inside of the vagina and the cervix to be examined.
Medicine is injected to numb the cervix (cervical block). If a cervical block is used, an oral pain medicine or pain medicine given into a vein (through an IV) may be used along with the local anesthetic.
What to expect after surgery
Most women are able to return to normal activities within 1 to 3 days after the procedure. Recovery time depends on how much was done during the procedure.
After LEEP:
When to call your doctor
Call your doctor now or seek immediate medical care if:
The loop electrosurgical excision procedure (LEEP) uses a thin, low-voltage electrified wire loop to remove abnormal tissue. LEEP is also known as large loop excision of the transformation zone (LLETZ).
Why it is done
LEEP is done after abnormal Pap test results have been confirmed by colposcopy and cervical biopsy. This method may be used to treat cell changes on the cervix such as:
- Minor cell changes called low-grade squamous intraepithelial lesions (LSIL) that may be precancerous and persist after a period of watchful waiting.
- Moderate to severe cell changes that can be removed.
LEEP is commonly used to:
- Cut away abnormal cervical tissue that can be detected during colposcopy
- Remove abnormal tissue located high in the cervical canal that cannot be seen during colposcopy. In this situation, LEEP may be done instead of a cone biopsy.
A vinegar (acetic acid) or iodine solution (which makes abnormal cells more visible) may be applied to the cervix before the procedure is performed.
How it is done
LEEP is usually done at your doctor's office, a clinic or other medical facility as an outpatient procedure. You do not have to spend the night in a hospital.
You will need to take off your clothes below the waist and drape a paper or cloth covering around your waist. You'll lie on your back on an exam table with your feet raised and supported by stirrups. Your doctor will insert a lubricated tool called a speculum into your vagina. The speculum gently spreads apart the vaginal walls, allowing the inside of the vagina and the cervix to be examined.
Medicine is injected to numb the cervix (cervical block). If a cervical block is used, an oral pain medicine or pain medicine given into a vein (through an IV) may be used along with the local anesthetic.
What to expect after surgery
Most women are able to return to normal activities within 1 to 3 days after the procedure. Recovery time depends on how much was done during the procedure.
After LEEP:
- Mild cramping may occur for several hours after the procedure.
- A dark brown vaginal discharge during the first week is normal.
- Vaginal discharge or spotting may occur for about 3 weeks.
- Pads should be used instead of tampons for about 3 weeks.
- Sexual intercourse should be avoided for about 3 weeks.
- Douching should be avoided.
When to call your doctor
Call your doctor now or seek immediate medical care if:
- You have severe vaginal bleeding (you are passing clots of blood and soaking through your usual pads each hour for 2 or more hours).
- You have pain that does not improve after you take pain medicine.
- You have signs of infection, such as:
- Increased pain
- Bad or foul-smelling vaginal discharge
- Fever
How well it works
LEEP is a very effective treatment for abnormal cervical cell changes. During the procedure, only a small amount of normal tissue is removed (around the edges of the abnormal tissue area).
After LEEP, the tissue that was removed (specimen) will be examined for cancer that has grown deep into the cervical tissue, which can assist with further diagnosis as well as treatment of the abnormal cells.
LEEP is as effective as cryotherapy or laser treatment. If all of the abnormal cervical tissue is removed, no further surgery is needed (although abnormal cells may recur in the future). In some studies, all the abnormal cells were removed in as many as 98% of cases.
Risks
Risks of LEEP include:
What to think about
A loop electrosurgical excision procedure (LEEP) is less expensive and easier to perform than cone biopsy or carbon dioxide laser treatment.
Before a LEEP is done, a biopsy is first performed to confirm abnormal cervical cell changes.
If you have LEEP, you will need regular follow-up Pap tests (which should be repeated every 4 to 6 months or as recommended by your health care provider). After several Pap test results are normal, you and your doctor can decide how often to schedule future checkups.
Source: WebMD Medical Reference
LEEP is a very effective treatment for abnormal cervical cell changes. During the procedure, only a small amount of normal tissue is removed (around the edges of the abnormal tissue area).
After LEEP, the tissue that was removed (specimen) will be examined for cancer that has grown deep into the cervical tissue, which can assist with further diagnosis as well as treatment of the abnormal cells.
LEEP is as effective as cryotherapy or laser treatment. If all of the abnormal cervical tissue is removed, no further surgery is needed (although abnormal cells may recur in the future). In some studies, all the abnormal cells were removed in as many as 98% of cases.
Risks
Risks of LEEP include:
- Infection of the cervix or uterus may develop (rare).
- Cervical stenosis, or narrowing of the cervix (which can cause infertility), may occur in rare cases.
- Higher risk in pregnant women (who were previously treated using LEEP) for preterm labor.
What to think about
A loop electrosurgical excision procedure (LEEP) is less expensive and easier to perform than cone biopsy or carbon dioxide laser treatment.
Before a LEEP is done, a biopsy is first performed to confirm abnormal cervical cell changes.
If you have LEEP, you will need regular follow-up Pap tests (which should be repeated every 4 to 6 months or as recommended by your health care provider). After several Pap test results are normal, you and your doctor can decide how often to schedule future checkups.
Source: WebMD Medical Reference
