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LEEP (Loop Electrical Excision Procedure)

Cervical LEEP is a procedure used to treat cervical dysplasia. Dysplasia is a precancerous change in the cervix. Many patients with abnormal PAP smears have an underlying dysplasia.

The treatment for dysplasia is to remove or destroy the abnormal skin. There are several treatment options:

  • LEEP
  • Cryosurgery
  • Laser surgery
  • Surgical ablation of the cervix
  • Cone Biopsy

How will I know I need treatment at all for my abnormal PAP?

If you have an abnormal PAP smear, your doctor will usually perform a procedure called colposcopy on you. Colposcopy involves looking at your cervix with a microscope in the office. Sometimes, if an abnormality is seen, small biopsies of the skin of the cervix will be obtained at the time of the colposcopy. The biopsies will be sent to a pathologist to determine if there is any dysplasia present. If there is dysplasia present, then you may be a candidate for treatment.

How is a LEEP procedure performed?

A speculum is placed just like for a PAP smear. The doctor will place a numbing medicine in the cervix (similar to what the dentists use to numb your teeth). After the cervix is numb, a special wire loop hooked up to a special electrical machine is used to remove the abnormal area. The procedure itself is usually painless. The whole procedure typically takes about 5 minutes to perform.

What happens to the tissue that is removed?

The tissue that is removed is sent to the pathologist to make sure that all the dysplasia was removed.

What are the risks?

Most women do not have any problems afterward. The most common problem is abnormal bleeding from the cervix which can occur even several days after the procedure. Infections are very rare. There is also some theoretical risk of damage to or weakening of the cervix which can result in fertility problems in the future, or complicate pregnancy. These risks increase with the amount of tissue that needs to be removed in order to cure the dysplasia.

What are the results?

A small percentage of women may have a recurrence or persistence of the dysplasia afterward. It is, therefore, important to have regular follow-up visits for PAP smears afterward.

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