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The LEEP Procedure
What is it?
So your doctor tells you that you need to undergo a "leap"
procedure. To you, it sounds like you're being asked to leap off the
top of a tall building. Somehow, this doesn't really sound like a
bona fide medical procedure. What is it and why do you need it?
Although pronounced "leap," the procedure is actually LEEP, or
loop electrosurgical excision procedure. When performing LEEP,
the doctor will use a loop electrode to remove a portion of the
cervix. During LEEP, a high-intensity electrical current is passed
through the loop-electrode, allowing the doctor to shave off a thin
slice of cervical tissue. This slice of tissue can be examined under
a microscope to check for abnormal cells, if the purpose of LEEP
was diagnosis. LEEP can also be used to remove any tissue that
may be found to be cancerous or pre-cancerous once it is found. A
local anesthetic is administered to the patient before the
procedure, and sometimes pain medication is prescribed to ease
postoperative discomfort.
This "growth" that the doctor is removing is a vague term. Most
"growths" removed by this procedure will be determined to be
what is called "cervical dysplasia." Cervical dysplasia is a term
used to describe abnormal cells that are at high risk of becoming
cancerous, but are not cancer yet. Whatever the results of
microscopic evaluation, the problem is often cured by the L.E.E.P.
Therefore, L.E.E.P. is both a biopsy and a removal of the
abnormal tissue (a cure if you will) all at once.
What causes abnormal tissue?
LEEP involves the removal of abnormal cellular growth found on
the cervix. This growth is called cervical dysplasia. Cervical
dysplasia is frequently found to be the result of human
papillomavirus (HPV) types 31 or 33. HPV, also known as genital
warts, is typically sexually transmitted.
Possible Dangers
LEEP is a fairly risk free procedure, if done correctly. However,
since it is so simple and fast there is criticism that it is being used
too frequently and by people who have not been properly trained in
its use. The primary danger with LEEP is an inadvertent removal of
too much tissue from the cervix. If a woman's Pap smear returns
"abnormal," it is a good idea for her to first explore her options with
her doctor before entering any procedure. There is a scale by
which a doctor measures the seriousness of abnormalities and
less serious ones do not need to be treated so aggressively. Many
Pap smears that are abnormal can be addressed by simply
waiting and returning for another Pap smear in six months, as
lesions often disappear without surgery. Remember that it is
always a good idea to get a Pap smear done in the middle of the
menstrual cycle for the most precise results.
What happens afterwards?
Immediately after the procedure, most women experience some
discomfort, and may have a small amount of discharge. Women
who have just undergone a LEEP should avoid tampons,
intercourse, and heavy lifting for four weeks after the procedure.
Usually, patients who undergo LEEP do not experience other
problems or recurrences later. After the procedure, most women
will have repeat Pap smears every 3 to 4 months (or every 4 to 6
months) for about 2 years, just to be sure that they do not have any
recurrences of abnormal cellular growth. Most recurrences are
detected within the first 2 years after the procedure, and they are
rare.
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