Loop Electrosurgical Excision Procedure
(LEEP, LLETZ—Large Loop Excision of the Transformation Zone, LLEC—Large Loop Excision of the Cervix, Loop Cone Biopsy of the Cervix)
Reasons for Procedure
- Abdominal cramping
- Future pregnancy problems (small increased risk of premature births and having a low birth weight baby)
- Narrowing of the cervix (very rare)
- Incomplete removal of the abnormal tissue
- Accidental cutting or burning of normal tissue
What to Expect
Prior to Procedure
Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure, like:
- Anti-inflammatory drugs (eg, aspirin )
- Blood thinners, such as clopidogrel (Plavix) or warfarin (Coumadin)
- If your doctor will be giving you a sedative, arrange for someone to drive you home from the clinic.
- If directed by your doctor, take a pain reliever right before the LEEP.
- Bring sanitary napkins to use after the procedure.
Description of the Procedure
How Long Will It Take?
How Much Will It Hurt?
- Dark brown-black vaginal discharge for several days
- Mild cramping
- Watery pink discharge
- Rest when you get home.
- Frequently change the sanitary pad.
- Take pain medicine as directed.
It will take a few weeks for your cervix to heal. For four weeks:
- Do not use tampons or douches.
- Refrain from sexual intercourse.
- Do not do any heavy lifting.
- It is okay for you take baths and showers.
- If advised by your doctor, have a Pap test and pelvic exam every six months.
Call Your Doctor
- Heavy bleeding (more than your normal period)
- Bleeding with clots
- Severe abdominal pain
- Fever or chills
- Unusual odor or discharge
American Academy of Family Physicians http://www.aafp.org/
American Congress of Obstetricians and Gynecologists http://www.acog.org/
Canadian Women’s Health Network http://www.cwhn.ca/
Society of Obstetricians and Gynaecologists of Canada http://www.sogc.org/
American Congress of Obstetricians and Gynecologists. Management of abnormal cervical cytology and histology. Practice Bulletin. 2010; 99.
Emam M, Elnasar A, Shalen H, Barakat R. Evaluation of a sinfle-step diagnosis and treatment of premalignant cervical lesions by LEEP. Int J Gynaecol Obstet . 2009;107(3):224-7.
LEEP patient pamphlet. American College of Obstetricians and Gynecologists website. Available at: http://www.acog.org/publications/patient%5Feducation/bp110.cfm . Accessed April 10, 2009.
Neff D. Endometrial ablation. EBSCO Health Library website. Available at: http://www.ebscohost.com/healthLibrary/ . Updated May 2009. Accessed September 30, 2009.
Noehr B, Jensen A, Kjaer SK. Depth of cervical cone removal by loop electrosurgical excision procedure and subsequent risk of preterm delivery. Obstet Gynecol . 2009;114(6):1232-8.
Patient fact sheet: LEEP. American Society for Colposcopy and Cervical Pathology website. Available at: http://www.asccp.org/pdfs/patient%5Fedu/leep.pdf . Accessed April 10, 2009.
- Reviewer: Andrea Chisholm, MD
- Review Date: 11/2012 -
- Update Date: 11/26/2012 -