You may have felt a little scared and nervous when your doctor told you that there was something abnormal in your Pap smear results. Then, the doctor may have told you that you need to undergo a procedure called LEEP. So, upon hearing this name, you may have thought, "Oh, what is this going to do?" Don't be scared. Today, we will talk about this LEEP procedure in a very simple way that you can understand.
What exactly is LEEP?
Simply put, LEEP is a minor surgical procedure that removes a strip of abnormal cells from the surface of your cervix. LEEP stands for Loop Electrosurgical Excision Procedure . Let's break it down a bit.
- Loop: refers to a small wire loop.
- Electrosurgical: This means that a subtle electrical current is sent through this wire loop.
- Excision Procedure: The process of cutting and removing something.
Do you understand now? LEEP is a procedure that uses a small wire loop that uses electricity to cut out and remove the area with the abnormal cells.
The removed tissue is then sent to a lab to check for cancer cells or precancerous cells. This precancerous condition is called cervical dysplasia . It is not cancer. However , if left untreated, it can develop into cervical cancer over time . That is why doctors recommend removing these abnormal cells early.
Your doctor will usually recommend a LEEP after a Pap smear or colposcopy. It is also used to treat conditions like cervical polyps and genital warts.
How do you prepare for a LEEP?
There are certain things you need to be aware of before undergoing this treatment. The doctor will give you clear instructions on this.
First, the doctor will check if you have any medical conditions that would prevent you from undergoing this treatment. For example:
- If you have a condition like Pelvic Inflammatory Disease (PID).
- If you have a condition like cervicitis.
In these cases, a LEEP is not performed. You may also be tested to see if you are pregnant. If you are pregnant, your doctor will determine the best time to perform the LEEP. The treatment will be scheduled for a day when you are not having your period .
Let's look at the table below to see how you can prepare before treatment.
| What to prepare for | Description and things to remember |
|---|---|
| Sex and creams | Avoid sexual intercourse for 24 hours before treatment. Also, do not use any vaginal creams. |
| Sanitary pads | After the treatment, you may experience some vaginal discharge. Bring a pad to use for this. |
| Blood thinners | If you are taking blood-thinning medications like aspirin, be sure to tell your doctor about it. He or she may ask you to stop taking the medication for a few days. |
| Painkillers | Your doctor may recommend that you take a pain reliever (e.g., Ibuprofen, Panadol) about 30 minutes before the treatment. This will help reduce discomfort during the treatment. |
| Clothing | Wear loose-fitting clothing that is easy to remove. You will be given a separate gown to wear at the hospital. |
What happens during treatment?
This treatment takes about 10-20 minutes to perform. It can be done in your gynecologist's office, in a hospital, or in an outpatient department. You are awake during this time. You will not feel any pain, except for a little discomfort.
1. Preparation
It starts just like a regular pelvic exam. You will be asked to lie down on an examination table with your legs in stirrups. Since the LEEP uses electricity, a grounding pad will be placed on your thigh to protect you. Then, the doctor will insert a device called a speculum to widen your vagina and make sure your cervix is clearly visible.
2. Making abnormal cells visible
Next, a liquid, such as acetic acid, is applied to the cervix to make it easier to see any abnormal cells. Then, a device called a colposcope is inserted near the vagina. This magnifies the cervix. It's like a magnifying glass. This device is not inserted into the body.
3. Cervical dilation
Now the doctor will numb your cervix. This is done by giving a small injection of a numbing medicine, such as lidocaine . This will cause a stinging and burning sensation, similar to the injection you get in your gums before a tooth extraction. The epinephrine in this medicine may make your heart beat a little faster and make you feel dizzy. But don't worry, it will go away completely in a few minutes.
4. Removal of abnormal tissue
After the cervix is dilated, the doctor will carefully cut away the abnormal tissue with the wire loop that is connected to the electricity. It is very important that you do not move at all during this time. Sometimes another loop may be used to remove cells further up the cervix. You may feel a warm sensation or a slight vibration during this time.
5. Stop bleeding
Finally, to stop the bleeding and prevent further bleeding, the doctor applies a special paste (Monsel's paste) to the wound.
If you feel a lot of pain throughout the process, never be afraid to tell the doctor or nurse about it.
What are the benefits and risks of this?
LEEP is a very safe procedure . Complications are rare. Another big advantage is that it can be done without full anesthesia.
As with any surgery, there is a small risk of infection and bleeding. Also, since the cervix may be slightly weaker after LEEP treatment, there is a small risk of preterm birth if you become pregnant in the future. If you have any concerns or questions about this, talk to your doctor before the treatment.
But these risks are actually very small compared to the benefits. The biggest and most important benefit here is that it removes cells that could lead to cervical cancer and protects you from cancer.
What happens after treatment?
After the treatment is over, you can go home. You will probably be asked to rest for 30-60 minutes. At that time, the doctor and nurses will explain the instructions you need to follow at home. Ask any questions you may have at that time.
You can expect the following during your recovery.
| What to expect | Description |
|---|---|
| Stomach ache (Cramping) | During the first few days, you may experience mild stomach cramps, similar to those experienced during menstruation. This can be controlled by taking a painkiller prescribed by your doctor. |
| Vaginal discharge/spotting | A vaginal discharge may occur for 1 to 3 weeks. At first, the discharge may be greenish-yellow and have a slight unpleasant odor. Later, a brownish-black discharge may appear. This is completely normal . Use pads for this. Do not use tampons. |
| Inconvenience | You may feel some pain or discomfort inside the vagina or abdomen. You may feel a tingling sensation in the cervical area, similar to a pinched nerve. This will go away after a few days. |
| Monthly menstruation | This treatment will not have a major impact on your monthly menstrual cycle. It will continue as normal. |
Things to avoid during recovery
It takes about 4-6 weeks for the cervix to fully heal. During this time, you should avoid certain things.
- Exercise and Strenuous Work: Avoid strenuous work for 48 hours after treatment. Do not exercise for at least a week. If you start exercising after a week and experience bleeding (not your period), stop exercising and give your body some more time to heal.
- Sexual intercourse: Avoid sexual intercourse for at least 4 weeks . Also, do not insert anything into the vagina, such as tampons or sex toys.
- Bathing: It's okay to take a regular shower. However, avoid soaking in a bathtub or swimming pool until your doctor gives you permission.
What happens after the LEEP results are received?
As we discussed earlier, LEEP is both a diagnostic and a therapeutic procedure. In most cases, removing the abnormal strip of cells will resolve the problem.
But sometimes, if the abnormal cells are not completely removed, another LEEP may be needed. Also, if you have a high-risk strain of the Human Papillomavirus (HPV) , there is a small chance that abnormal cells will develop again in the future.
The important thing is that LEEP removes abnormal cells caused by the HPV virus. However, it does not remove the HPV virus itself from the body.
Therefore, even after treatment, it is very important to have Pap tests and HPV tests at the scheduled times as recommended by the doctor.
When do you need to see the doctor?
If you experience any of the following symptoms, call your doctor or go to the hospital immediately . These may be signs of an infection.
- Heavy bleeding (more than your normal monthly period)
- Blood clots
- Strong odor from vaginal discharge
- Fever
- Severe stomach ache
It's normal to feel scared when you hear about a LEEP. But remember, this is done without any significant pain because your cervix is being numbed. The potential for future cancer is far greater than the discomfort of these 10-20 minutes. Don't hesitate to talk to your doctor about any questions or concerns you may have about this procedure.
Take-Home Message
- LEEP is a very safe and effective treatment that removes abnormal cells that could develop into cervical cancer.
- This is done by dilating the cervix, so the pain and discomfort are minimal.
- It is normal to experience vaginal discharge and mild stomach cramps for a few weeks after treatment. Don't worry about that.
- Follow your doctor's instructions carefully during your recovery, especially regarding avoiding sexual intercourse and exercise.
- If you experience warning signs such as excessive bleeding, fever, or severe pain, seek medical advice immediately.
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