It's normal to feel a little scared and nervous when your doctor tells you that your Pap smear results are a little different. Then, when he or she tells you that you need to have a LEEP procedure, that fear can be even greater. It's natural to wonder, "What is this going to do?" But what exactly is LEEP? Is it dangerous? Let's talk about it clearly, in a way that you can understand, as if you were talking to a friend.
What is LEEP in simple terms?
Simply put, LEEP (Loop Electrosurgical Excision Procedure) is a minimally invasive procedure that removes a layer of abnormal cells from the surface of your cervix. Much like gently peeling the skin off a vegetable, this layer of abnormal cells is removed with a small wire loop that uses electricity.
Now you may be asking, "Why are these cells being removed?" If your Pap smear or colposcopy reveals abnormal cells on your cervix, your doctor may recommend this LEEP procedure. This abnormal cell condition is called cervical dysplasia .
The important thing is that this `(Cervical Dysplasia)` is not cancer. However, if left untreated for a long time, a small percentage of these cells can turn into cervical cancer. So LEEP treatment is a very important and effective method to eliminate the possibility of cancer before it develops . It is also used to remove some cervical polyps and genital warts.
How do you prepare before treatment?
Before performing this procedure, your doctor will check to make sure everything is in order. For example, if you have pelvic inflammatory disease (PID) or cervicitis, these will need to be treated before performing LEEP.
You may also be tested to see if you are pregnant. If you are pregnant, your doctor will choose a time that is most suitable for you to perform this treatment. Usually, this is done on a day when you are not having your period.
It is very important to follow the doctor's instructions exactly before treatment.
- Avoid having sex and using any vaginal creams for 24 hours before treatment.
- Bring a sanitary pad to use after treatment.
- If you are taking medication that prevents blood clotting (like aspirin), you should definitely tell your doctor about it and seek his advice.
- If your doctor recommends it, take a pain reliever (like Panadol) about 30 minutes before the treatment.
- When dressing, wear comfortable, loose clothing that can be easily removed.
What happens during LEEP treatment?
This can usually be done in the doctor's office or in the hospital's outpatient department. The entire treatment only takes about 10 to 20 minutes. You are awake during this time, but you won't feel much pain.
1. Preparation: First, you will be asked to lie down on an examination table, as you would for a regular gynecological examination, with your legs in stirrups. Then, a grounding pad will be placed on your thighs. This will protect you from the electricity used during the treatment. Then, the doctor will insert a device called a speculum and slightly widen your vagina so that your cervix can be clearly seen.
2. Identifying abnormal cells: Next, a special liquid (acetic acid or iodine solution) is applied to the cervix to make the abnormal cells more visible. A magnified camera-like instrument called a colposcope is inserted near the vagina and examined. This is an instrument that is placed outside the body.
3. Cervical Dilation: This is the part that many people are afraid of. But there is nothing to be afraid of. The doctor will inject a numbing injection (`(Lidocaine)` with `(Epinephrine)`) into your cervix with a very fine needle . It will feel like a tingling sensation in your gums when you have a tooth pulled, like a small needle being inserted, and then you will feel a slight burning sensation for a few seconds . The `(Epinephrine)` in the injection may make your heart beat a little faster and you may feel a little dizzy . It will completely go away in a few minutes, so don't worry about it.
4. Abnormal tissue removal: After the cervix is completely numb, the doctor will use an electric wire loop to cut away the abnormal tissue. It is important that you remain still during this time. You may feel a slight tingling sensation, but not pain. Sometimes this may be done a second time to remove any cells that are further down the cervix. The tissue sample will be sent to a lab to be tested for cancer cells.
5. Stop the bleeding: Finally, a special medicinal paste (Monsel's paste) is applied to the wound to stop the bleeding and prevent infection.
What to expect after treatment?
After the treatment is over, you will be sent home after resting until you are fully recovered (about 30-60 minutes). During this time, you can ask your doctor if you have any questions. After you go home, there are some things you need to follow, as well as changes in your body while you recover.
| What you will experience | What you should and shouldn't do |
|---|---|
| Cramping You may feel a little pain, like during menstruation, for a few days. | Take painkillers (e.g. Panadol) as directed by your doctor. |
| Vaginal Discharge A greenish-yellow or brownish-black discharge, sometimes with an unpleasant odor, may be present for 1-3 weeks. This is because the last applied medication paste is dissolving and coming out. | Use sanitary pads. Do not use tampons or anything inserted into the vagina for any reason. |
| Activities and exercises You need to give your body time to heal. | Avoid strenuous activity for the first 48 hours. Avoid exercise for at least a week. |
| Sexual relations The cervix must be completely healed. | Avoid sexual intercourse completely for at least 4 weeks . |
| Bath | You can take a shower as usual, but avoid getting into water (in a sink, bathtub, sea/river) until your doctor tells you to. |
Will the cervix regrow?
Yes. The removed tissue is replaced by new, healthy cells and the cervix returns to normal. This takes about 4-6 weeks.
When to see a doctor immediately
If you experience any of the following symptoms, it could be a sign of an infection. So call your doctor or go to the hospital right away.
- Heavy bleeding beyond normal menstrual flow (wetting more than one pad per hour)
- Passing large blood clots
- A strong-smelling vaginal discharge that gets worse day by day
- Fever
- Unbearable severe stomach pain
What happens after the results come in?
LEEP is a diagnostic and therapeutic procedure. In most cases, once the abnormal cells are removed, the condition is completely cured.
However, sometimes if the report shows that there are abnormal cells at the margins of the removed tissue, it may be necessary to perform another LEEP treatment to remove any remaining cells.
Another thing to remember is that the main cause of these abnormal cells in the cervix is a virus called HPV (Human Papillomavirus) . LEEP treatment only removes the abnormal cells caused by the virus, not the virus itself . Therefore, even after treatment, it is important to have regular Pap smears as recommended by your doctor.
Take-Home Message
- LEEP is a very safe, quick, and effective treatment that removes abnormal cells that may lead to cervical cancer before it develops.
- This is done by numbing the cervix, so you won't feel much pain. You may feel a little discomfort when the numbing injection is given.
- It is normal to experience lower abdominal pain and vaginal discharge for a few weeks after treatment.
- Follow your doctor's instructions exactly, especially those about avoiding sexual intercourse and exercise.
- If you experience symptoms such as excessive bleeding, fever, or severe pain, see a doctor immediately.
- Any questions or concerns you may have about this treatment should be discussed with your doctor. It is your right.
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