How effective is a LEEP procedure?
Loop electrosurgical excision procedure (LEEP) is used to remove abnormal or potentially cancerous regions in the cervix (mouth of the uterus). Research has shown that this procedure is as effective as other treatments (laser ablation, cold knife conization and cold therapy or cryotherapy) that are used to destroy or remove the suspicious areas in the cervix.
A recent study in a low-income country found that nearly 70 to 90 out of every 100 women with cervical intraepithelial neoplasia (CIN) were cured with LEEP. These results are similar to studies conducted in moderate- to high-income countries.
What is a LEEP?
A LEEP procedure is a simple procedure that involves the use of an electric current passed through a loop of wire to destroy suspicious cells in the cervix.
It is usually done after a Pap smear test that shows abnormal results. A LEEP procedure is done as the next step to remove the abnormal portion and send the sample to the lab to get a correct diagnosis.
How to prepare before a LEEP
Women should schedule the appointment for the LEEP procedure only before or after their periods (never when they are menstruating).
Women just need to take a few simple precautions for two days before the procedure
- Do not have sex (vaginal intercourse).
- Do not use tampons or vaginal douches.
- Do not use vaginal creams.
- Do not take an over-the-counter pain medication.
Also, let women should let their doctor know
What happens during a LEEP?
A LEEP procedure is usually done in a doctor's office or clinic and typically takes 10 to 20 minutes.
- The woman will be asked to lie down on a table in the same position (stirrup position) as during a pelvic examination or Pap test.
- The doctor will then insert a special instrument (speculum) into the vagina that helps stretch (dilating) it open.
- Next, a long camera-like tube (colposcope) is placed just near the vulva (but not inside) in such a way that it lights the entire path from inside the vagina up to the cervix. This allows the doctor to visualize the vagina, vulva and cervix.
- The doctor then clears the area of mucus or other discharge.
- The anesthetic medication is injected (locally) into the cervix to numb it and ensure the woman is pain-free during the procedure.
- The doctor may apply a solution containing acetic acid or vinegar to the cervix, which may cause a mild burning sensation. This solution highlights the abnormal regions in and around the cervix.
- The doctor then inserts an electrically charged loop of wire into the cervix. This loop is passed through all abnormal areas in the cervix to cut out a thin layer, thereby removing the abnormal tissue.
- A small piece (biopsy) of the removed tissue is sent to the laboratory for examination under a microscope. The biopsy results show if the abnormality is due to the presence of precancerous cells.
What is done after a LEEP?
The doctor will ask the woman to rest for a few minutes before she goes home the same day of the procedure.
The woman can wear a sanitary pad before leaving the doctor’s office because there may be mild bleeding after the procedure. It is normal to have some mild spotting followed by dark or black-colored discharge for several days.
The woman will usually have to avoid the following things for four weeks after the procedure
- Using tampons
- Having sex
A woman who’s undergone a LEEP procedure should avoid excessive activity and rest as much as she can for 48 hours after the procedure.
She should avoid strenuous activities, such as jogging, heavy workouts and heavy lifting, for at least a week or as instructed by the doctor.
A woman’s healthcare provider will tell her when to follow up for further treatment or care.
Does the LEEP carry any risks?
LEEP is a relatively safe procedure with minimal risk of complications. Rarely, there are chances that a woman may get
- Infection (treated by a short course of antibiotics)
- Scarring in the cervix
- Trouble conceiving or getting pregnant
- Early labor
The doctor will discuss all these risks with the woman before the procedure. She should discuss any and all concerns she may have with her doctor.
A woman should call the doctor right away if she experiences any of the following after the procedure
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International Journal of Gynaecology and Obstetrics