Information
About LEEP Treatment
The Loop Electrocautery Excision Procedure (LEEP)
is used to diagnose (find out what
is the abnormality) and to treat (remove) most abnormal
tissue problems on the outer and inner cervix, vagina
and vulva. The LEEP treatment is about 92% effective
in completely removing the precancerous changes. However,
there is a small chance (8%) that these precancerous
changes may have invisibly spread to another area of
the cervix, vagina or vulva and may be in such an early
phase that it is not yet possible to see them through
the colposcope.
In order to determine that you are among the 92% of women who have been treated
fully, you will need to have Pap smears performed every three months for one
year after the LEEP treatment. If you have any persistent abnormality, it will
be found on one of these Pap smears. Usually the abnormality is the same as the one you have been treated for…but the abnormalities were too small to visualize with the naked eye.
After this first year, you will need a Pap smear only once a year for the rest
of your life. While the American Cancer Society has said that some women only
need a Pap smear every three years, you will not fit into this low risk category.
So please take good care of yourself by obtaining a Pap smear every three months
for one year and then every year for the rest of your life. And if you are not
in a monogamous relationship, use safer sex techniques always.
Before Your LEEP:
- Take 800 mg of Ibuprofen or Naprosyn/Naproxen Sodium
between 1 and 3 hours before your scheduled procedure.
- Your nurse will tell you everything about the procedure
and how it will feel when you arrive. You will be
comfortable throughout the procedure. It is quite
civilized. Most patients feel it is less uncomfortable
than a colposcopy
- You will be able to drive yourself home, or go
back to work.
After Your LEEP:
Once the procedure is done, there is no further discomfort for most women.
However, a very few women will have some cramping. If you have any cramping afterwards,
take another 600 mg of Ibuprofen or Naprosyn/Naproxen Sodium about 6 hours after
the first dose. This cramping will diminish and go away entirely. Please notify
us if your cramps last longer than one day.
You may experience some vaginal bleeding over the
next few days, but many women will spot for 1-5 weeks,
and resume their normal menstrual cycles after that.
If you do start to bleed, remember that your menstrual
period may, in fact, be occurring -- consider the time
of month and whether you might actually be due to begin
your regular menstruation. Your period may also come
slightly early or slightly late this month. If you
are taking oral contraceptives, do not interrupt the
cycle. Continue taking the pills as you have been instructed.
Many women experience a vaginal discharge for four
to six weeks after LEEP treatment. This discharge can
be white, yellow, brown or tan and may be smooth or
lumpy. Its odor may be different from your usual vaginal
discharge. This vaginal discharge is part of the healing
process of your cervix and is entirely normal. It will
stop when the healing is complete. Please notify us
if the discharge persists for over a month or becomes
worse, as you may have a vaginitis which can be treated
with a vaginal antibiotic cream.
Some women may feel a bit tired for a few days after
the LEEP treatment but most will continue with their
usual energy. Feel free to do whatever exercise or
work you are accustomed to doing. There is no incision
to protect. Activity will not make you bleed.
How long before I can continue sexual relations after the LEEP treatment?
You may continue to enjoy your sexuality after the
LEEP treatment; however, vaginal penetration
should be avoided for four weeks after treatment. Expect
to have some spotting if vaginal penetration is undertaken
before the 4th week. This is not a problem. If any
bleeding occurs that is greater than a menstrual
period, please contact us.
The LEEP treatment will have no effect on your ability
to become pregnant, carry and deliver a baby. Only
after multiple or very deep LEEPs, does the cervix
become somewhat smaller and weakened. You continue
to need to use birth control until you choose to become
pregnant.
Monitor your own health for the next week or so. If
you should develop vaginal bleeding that is heavier
or longer than your normal menstrual period, pain that
is increasing, temperature in excess of 100.4 °F or shaking chills, please
contact us immediately. If you feel sickly or have persistent pelvic discomfort
after LEEP therapy, please call us.
When to have you next Pap Smear.
If all goes well after your LEEP treatment, as most
often is the case, then you will need to obtain your
first post-treatment Pap smear three months from the
procedure, and every three months for a year. After
a year of abnormality-free paps, the abnormality is
technically gone and you need only yearly paps for
the rest of your life. If any of your four follow-up
Pap smears are abnormal, and 8% or so are, do not worry,
you simply need to return for repeat colposcopy and
possibly a subsequent LEEP treatments to "touch-up" some area that
could not be seen before. These re-treatments are almost always much less extensive
than your initial treatment and can be done fairly easily in the office with
the same likelihood of success. If you have any further questions, please do
not hesitate to discuss them with us.
Stop smoking if you want to maximize your chance for
cure with these treatments. Smoking suppresses the
immune system from being able to fight the HPV infection. The
carcinogens from cigarettes go through your blood, into the cervical mucus, and
are potent promoters of cancer growth. Research shows that smoking helps cervical
cancer grow. Also consider getting the HPV vaccine Gardasil to help your
immune system fight the HPV infection.
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