LEEP is a procedure performed in the office that removes abnormal tissue from the cervix. The Pap smear is a screening test for cervical cancer that can detect abnormal or precancerous changes in the cervix. The LEEP procedure (Loop Electrocautery Excision Procedure) uses a special wire loop electrode to remove the abnormal or precancerous cells. In most cases, the LEEP procedure will cure that patient and future Pap smears will return to normal.
Loop Electrosurgical Excision Procedure (LEEP) Abnormal Pap smear results are common at Minnesota Gynecology and Aesthetics. Dr. Erhard has performed thousands of LEEP procedures… However, they can create a lot of anxiety and stress for the patient who has an abnormal result. There are many different types of abnormal Pap smears including ones with atypical cells, low-grade dysplasia and high-grade dysplasia (pre-cancer), non-invasive cancer and invasive cancer. The way an abnormal Pap test is managed depends on patient’s age and the specific result and ranges from observation or a follow-up Pap smear to performing a colposcopy or referral to a gynecologic oncologist. A colposcopy is a minor procedure performed in the office which looks more closely at the cervix with a microscope and sometimes includes a cervical biopsy and/or an endocervical curettage. Occasionally, high grade dysplasia (CIN2-3) is discovered and a patient needs a Loop Electrosurgical Excision Procedure (LEEP). A LEEP procedure removes a piece of the outer portion of the cervix to eradicate the disease. This procedure is usually done under local anesthesia (numbing of the cervix) in the office and is 90-95% curable.
LEEP uses a thin wire loop electrode which is attached to an electrosurgical generator. The generator transmits a painless electrical current that quickly cuts away the affected cervical tissue in the immediate area of the loop wire. This causes the abnormal cells to rapidly heat and burst and separates the tissue as the loop wire moves through the cervix.
This technique allows Dr. Erhard to send the excised tissue to the lab for further evaluation which insures that the lesion was completely removed, as well as allowing for a more accurate assessment of the abnormal area.
You may want to take some over-the-counter pain reliever such as ibuprofen before arriving at our Wayzata office for the procedure. This will help minimize any pain during or following the procedure. Always follow Dr. Erhard’s instructions for preparation for the LEEP.
What happens during the LEEP procedure?
The LEEP procedure takes about 20-30 minutes and is performed in our Wayzata office. In some ways it may seem much like a normal pelvic exam because you will lie on the exam table with your feet in the stirrups. A colposcope will be used to guide Dr. Erhard to the abnormal area. Unlike a normal colposcopy, a tube will be attached to the speculum to remove the small amount of smoke caused by the procedure.
An electrosurgical dispersive pad will be placed on your thigh. The pad is a gel-covered adhesive electrode which provides a safe return path for the electrosurgical current. A single-use, disposable loop electrode will be attached to the generator hand piece by Dr. Erhard. Your cervix will be prepared with acetic acid and iodine solutions that enable your physician to more easily see the extent of the abnormal area. Next a local anesthetic will be injected into the cervix; the electroloop will be generated and the wire loop will pass through the surface of your cervix.
After the lesion is removed Dr Erhard will use a ball electrode to stop any bleeding that occurs; She may also use a topical solution to prevent further bleeding. You can leave our Wayzata office soon after the procedure.
Are there any complications associated with the LEEP?
Complications are usually mild but can include:
Mild pain or discomfort
After the LEEP you should not:
Have sexual intercourse for as long as recommended by Dr. Erhard
Lift heavy objects
Take tub baths/Take showers only to prevent infection