Loop Electrosurgical Excision Procedure (LEEP)
(Large Loop Excision of the Transformation Zone [LLETZ], Large Loop Excision of the Cervix [LLEC], Loop Cone Biopsy of the Cervix)
What is a loop electrosurgical excision procedure (LEEP)?
Loop electrosurgical excision procedure (LEEP) uses a wire loop heated by electric current to remove cells and tissue as part of the diagnosis and treatment for abnormal or cancerous conditions in a woman’s lower genital tract.
The lower genital tract includes the cervix and vagina. The cervix is the lower, narrow part of the uterus (womb) and the vagina connects the cervix and the vulva (the external genitalia).
With LEEP, an electric current passes through the fine wire loop to cut away a thin layer of abnormal tissue. This tissue will be sent to the lab for examination. LEEP can also remove abnormal cells to allow healthy tissue to grow.
Other related procedures that may be used to diagnose cervical and vaginal conditions include Pap test, cervical biopsy, and colposcopy. Please see these procedures for additional information.
What are female pelvic organs?
The organs and structures of the female pelvis are:
Reasons for the procedure
LEEP may be performed when cervical or vaginal problems are found during a pelvic examination, or abnormal cells are found during a Pap test. LEEP is also performed to detect cancer of the cervix or vagina.
Cells that appear to be abnormal, but are not cancerous at the present time, may be identified as precancerous. The appearance of these abnormal cells may be the first evidence of cancer that could develop years later.
LEEP may also be used to assist in the diagnosis or treatment of the following conditions:
There may be other reasons for your health care provider to recommend LEEP.
Risks of the procedure
As with any surgical procedure, complications may occur. Some possible complications may include, but are not limited to, the following:
Patients who are allergic to or sensitive to medications, iodine, or latex should notify their health care provider.
If you are pregnant or suspect that you may be pregnant, you should notify your health care provider.
There may be other risks depending on your specific medical condition. Be sure to discuss any concerns with your health care provider prior to the procedure.
Certain factors or conditions may interfere with LEEP. These factors include, but are not limited to the following:
Before the procedure
During the procedure
LEEP may be performed in a health care provider’s office, on an outpatient basis, or as part of your stay in a hospital. Procedures may vary depending on your condition and your health care provider’s practices.
Generally, LEEP follows this process:
After the procedure
After LEEP, you may rest for a few minutes after the procedure before going home.
You may want to wear a sanitary pad for bleeding. It is normal to have some mild cramping, spotting, and dark or black-colored discharge for several days. The dark discharge is from the medication applied to your cervix to control bleeding.
You may be instructed not to douche, use tampons, or have intercourse for four weeks after LEEP, or for a period of time recommended by your health care provider.
You may also have other restrictions on your activity, including no strenuous activity or heavy lifting.
Take a pain reliever for cramping or soreness as directed by your health care provider. Aspirin or certain other pain medications may increase the chance of bleeding. Be sure to take only recommended medications.
Your health care provider will advise you on when to return for further treatment or care. Generally, women who have had LEEP will need more frequent Pap tests.
Notify your health care provider if you have any of the following:
Your health care provider may give you additional or alternate instructions after the procedure, depending on your particular situation.