LEEP/LLETZ

What is LEEP/LLETZ?

LEEP is a procedure for removing a type of abnormal tissue growth in the cervix called cervical dysplasia. It uses a thin wire loop attached to an electrical unit.

The cervix is the narrow, lower portion of the uterus. The uterus is the muscular organ at the top of the vagina. Babies develop in the uterus, and menstrual blood comes from the uterus.

LEEP is an abbreviation for loop electrosurgical excision procedure. It is also referred to as large loop excision of the transformation zone, or LLETZ.

When is it used?

Cervical dysplasia is most often discovered from a Pap test, a test which most women should have every year. Several types of cervical dysplasia can become cancer if not treated. Removal of the abnormal cells can help prevent cancer of the cervix.

Examples of alternatives are:

• freezing, burning, or using a laser to remove the abnormal tissue
• surgical removal of the tissue with a knife
• removal of the uterus.

How do I prepare for LEEP?

Ask your health care provider how long you should avoid sex or douching before the procedure.

What happens during the procedure?

This procedure is done when you are not having your menstrual period.

You lie on a treatment table and put your feet in stirrups, just as you would for a pelvic exam. Your health care provider then looks at your vagina and cervix through a colposcope, which is like a magnifying glass. Your health care provider puts a solution on the cervix to highlight the problem areas on the cervix. Once your provider sees the area where the dysplasia is, he or she numbs the cervix with a local anesthetic. Your provider then removes the abnormal tissue with the wire loop. The loop is used to scoop out the abnormal tissue in one piece and to seal any bleeding blood vessels. A medicated paste is then put on the cervix to further reduce the risk of bleeding. All you may feel is a slight tingling. The procedure takes about 5 minutes.

The removed tissue is sent to a lab for testing.

What happens after the procedure?

You can return to normal school or work activity the same day. You may have a little cramping after the procedure. You may also have some minor bleeding or spotting the first day or so after the procedure. For about 2 weeks you will have a brownish discharge. This is a normal part of the healing of your cervix. Your cervix should heal completely within a month.

You should avoid heavy lifting, tampons, douching, sexual intercourse, and hot tubs for 1 month after the procedure.

See your health care provider for follow-up visits and Pap tests as recommended.

What are the benefits of this procedure?

LEEP allows your health care provider to locate and remove precancerous cells. It does not require a general anesthetic, which might be necessary if the tissue were removed surgically.

What are the risks of this procedure?

• You may have heavy bleeding.
• Rarely the cervix may become infected. Infection may cause the opening in your cervix to become narrower. The narrowing might make it more difficult for you to get pregnant.
• Sometimes the healing of the area from which the tissue was removed may cause the cervical opening to become narrower. The narrowing might make it more difficult for you to get pregnant.
• The tissue of the cervix may be weakened. This is called an incompetent cervix and it could cause a premature birth of a baby if you become pregnant.

When should I call my health care provider?

Call your health care provider right away if:

• You have a fever over 100°F (37.8°C).
• You have severe abdominal pain.
• You have any discharge from your vagina that has a bad odor.
• You have bleeding that lasts more than 1 week.

Call during office hours if:

• You have questions about the procedure or its result.
• You want to make another appointment.