LEEP Treatment: Loop Electrocautery Excision Procedure

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.

For more LEEP information call AOA: 972.276.9902

Before Your LEEP Procedure:

  1. Take 800 mg of Ibuprofen or Naprosyn/Naproxen Sodium between 1 and 3 hours before your scheduled procedure.
  2. 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
  3. You will be able to drive yourself home, or go back to work.

After Your LEEP Procedure:

Once the LEEP 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

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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