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LEEP of the Cervix PDF Print E-mail
Written by Dr Vasilev   
Tuesday, 13 July 2010 00:00
LEEP of the cervix or Loop Electrosurgical Excision Procedure is basically a large biopsy of the cervical area, done for dysplasia or pre-cancer.  It is a relatively minor type of surgery but can be anxiety producing if you do not know what's coming up.  What follows is a very basic explanation which should help. 
 
  
The entire procedure can be summarized using  the following pictures.  The physican or nurse practitioner inserts a speculum and prepares the cervix, usually including a local anesthetic injected directly into the cervix.  After that a special electrosurgical loop is carefully inserted through the speculum and a cone-shaped cervical biopsy is removed.  A smaller or "top hat" removal of the cervical canal above the bigger LEEP biopsy  is often performed.  Electrosurgical cautery and some medication which stops bleeding is then applied.  Finally, the inside of the cervix, above the LEEP level, is scraped using a sharp instrument.  This is called an ECC or endo-cervical curettage.  
 
 
 
 
The entire procedure, which is usually done in the doctor's office,  lasts about 10 minutes, including the preparation.
 
During the following two weeks you should watch for an increasing amount of discharge, fevers and pain, which might mean an infection is developing.  Also, bleeding is likely to happen in small amounts while the cervix heals,  However, if blood clots start coming out from the vagina, visiting your doctor or the emergency room is very prudent.
 
This procedure is similar to a "cold knife" or "laser cone" (not laser ablation), in that it removes tissue for the pathologist to examine for "margins".  What this means is that the pathologist can determine if the dysplasia was removed completely or if it was present near the edges of the area removed. With "clear margins" the chances are lower that the dysplasia will return. However, each circumstance is different and follow-up with your doctor is still required. Dysplasia does recur and re-infection with HPV, which causes dysplasia, can also occur.
 
Alternatives 
 
Please note that LEEP is NOT the only way to treat dysplasia.  Although this is primarily a cancer treatment site, I will add some more pages to describe dysplasia treatment alternatives such as cryosurgery (freezing) and laser ablation (vaporizing), as well as newer research directions and integrative prevention.  Meanwhile I should mention that these other methods do not remove tissue and because of this it is not possible to accurately assess whether or not the area was treated adequately and whether or not hidden invasive cancer was present.  In the case of hidden or unrecognized cancer, none of these treatments are adequate and there is a risk of recurrence not of dysplasia but of cancer.
 
However, options do exist, including safe observation of early dysplasia and all should be discussed with your trusted doctor.  If you do not have a trusted doctor, the best advice I can give you is FIND ONE and develop a trusted physician-patient relationship.  Since you are not likely a health-care provider, this is crucial to make the right informed decision.  
Last Updated on Tuesday, 13 July 2010 16:26
 
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