LEEP (Loop Electrosurgical Excision Procedure)

LEEP (Loop Electrosurgical Excision Procedure)
10 Jan 2024
9 mins
Table Of Content
LEEP (Loop Electrosurgical Excision Procedure)

    LEEP: Surgical Precision, A Cancer Prevention


    Cervical cancer is a commonly affecting cancer in women all over the world. Even though there are a lot of procedures available to treat and diagnose cervical cancer, LEEP (Loop electrosurgical excision procedure) has been considered the best tool to reduce the risk of cervical cancer, which plays a dual role in treating and diagnosing it. Today, we will explore the role of LEEP and its significance in cervical health. Continue to read for more information.


    Decoding LEEP: The Power to Protect Against Cervical Cancer


    LEEP (loop electrosurgical excision procedure) can be considered a surgical conization procedure, which involves the removal of the cone-shaped portion of the cervix. This procedure is used to diagnose cancer cells and to prevent the spread of precancerous cells in the cervix (cervical dysplasia). This precancerous cell will turn into cervical cancer if untreated. Patients who receive a positive result in a PAP smear or colposcopy may be recommended to undergo LEEP as a potential course of action.


    The LEEP procedure involves a small, thin, loop-shaped wire that is heated by an electrical current to remove the abnormal cell in the cervix. Based on the size and distribution of the lesion in the cervix, four categories of LEEP are used to remove the abnormal cells.


    • LEEP-A (large conization of cervical tissue)
    • LEEP-B (medium conization of cervical tissue)
    • LEEP-C (small conization/less than one-third of cervical tissue)
    • LEEP-D (endocervical canal resection)


    Steps Involved In LEEP


    LEEP includes several steps to remove the abnormal cells of the patients. It can be performed based on the following steps which are given below:


    1. Preparation:

    Your doctor will advise you to be positioned on the examination table and will place a grounding pad to avoid damage caused by the electricity. A vaginal speculum is placed for a proper view of the colposcopy (an instrument for examining the cervix) before using the LEEP. This will help to confirm the location and extent of the lesion.


    2. Anesthesia:

    Local anesthesia is provided to the patient before starting the surgery to avoid the pain caused during the procedure. The electrical loop can be inserted only after the onset of the anesthesia in the cervix (numbs).


    3. LEEP insertion:

    Your doctor or health care provider will insert an electrical loop to remove the abnormal cells in the cervix. The abnormal tissues or cells are then sent to the lab for further diagnosis.


    4. Post-Care:

    Individuals might experience some cramps or mild discomfort after the surgery. Your healthcare will advise you to avoid using the tampons and sexual intercourse after the procedure.


    5. Follow-Up:

    It is important to engage with your doctor or healthcare provider to ensure safety and fast recovery after the LEEP procedure. It will help to reduce the risk of complications and side effects after the surgery.

    However, it is important to note that the above steps for the LEEP might vary slightly based on the individual's health conditions and doctor's preference. Always consult your doctor for specific details and guidance regarding the procedure.


    Things To Remember!


    • Consult your doctor if you have Pelvic inflammatory disease (PID), cervicitis, vaginal trichomoniasis, or bacterial vaginosis before start treating the cervix with LEEP
    • Inform your doctor if you have persistent and severe abdominal pain, heavy bleeding/ vaginal discharge, fever, or foul discharge.
    • Consult your doctor if you are planning to get pregnant or think you may be pregnant before starting the LEEP procedure.
    • The healing procedure after LEEP usually takes place within a month. So, it is recommended that you follow your doctor's instructions and plan a follow-up session after the surgery.

    Side effects Of LEEP


    Some of the side effects of LEEP are given below:


    1. Vaginal bleeding: Individuals may experience vaginal bleeding after the procedure. It is advised to inform your doctor if you have heavy bleeding for more than two weeks.

    2. Preterm delivery: LEEP may increase the risk of preterm birth (before 37 weeks) in women who are pregnant after the surgery.

    3. Cervical stenosis: Patients who are undergoing the procedure may often experience blood accumulation in the uterus.

    4. Cervical incompetence: Women may experience cervical incompetence or cervical insufficiency (inability of the cervix to retain the fetus) due to the change in the volume of the cervix.

    5. Brown or black discharge: Patients may have a brown or black discharge for up to two weeks after the procedure. It is recommended to consult your doctor if it has persisted for more than two weeks.

    Success Rate


    Studies have shown that up to 73 to 99% of cure rates are reported in cervical intraepithelial neoplasia patients (CIN) by the LEEP procedure. CIN gradually develops into cervical cancer if not treated properly. Hence, LEEP helps to prevent the occurrence of cervical cancer in CIN patients. It also provides 100% accuracy in determining cervical cancer in patients, along with colposcopic guidance. 



    What is the advantage of LEEP over cryotherapy?

    If you are a CIN patient, it is recommended to go for LEEP rather than cryotherapy. LEEP helps to remove the abnormal cells, which can be sent to the lab for further diagnostic procedures, but in cryotherapy, the cells are destroyed, which blocks the option of histological examination. However, your doctor will decide on an appropriate treatment based on your health condition.

    Is there any instruction I need to follow after LEEP?

    LEEP patients should be recommended to avoid the use of vaginal douche, tampon, or have sexual intercourse for more than one month after the surgery.

    Should I need to do a PAP smear after LEEP?

    It is recommended to do an HPV and PAP smear after LEEP treatment to detect the residual or recurrence of CIN. This kind of follow-up will help to ensure cervical health and prevent the recurrence of CIN in patients. Consult your doctor for further details.

    Wrap it!


    LEEP has played an important role in managing cervical health by accurately diagnosing and removing abnormal cells. This dual role player has helped to prevent cervical cancer before it affects our women's health. Even Though LEEP has an enormous advantage over other methods, the side effects will make it more vulnerable to use in cervical care. Proper interaction with your doctor about the side effects and follow-ups after surgery will reduce the complications caused by the LEEP. Also, it is advised to make sure that the removed cells or tissues are noncancerous and to undergo a regular PAP smear examination to avoid the risk of cervical cancer. Let's use LEEP and break the fear of cervical cancer.

     The best protection is early detection!

    Written by
    Ishwarya RMedical content writer
    AboutIshwary R is a Medical Content Writer at MrMed. She completed her PG from the University of Madras, Chennai. She did her final year project in CSIR-CLRI, Adyar, entitled Studies on production of Biosurfactant by bacillus subtilis using Leather industry bioproduct. She did her offline internship and learned clinical Laboratory skills in Billroth hospital and her online internship in SS Healthcare. She strengthened her skills in research, writing, editing, and proofreading medical content, blogs, and scientific articles.
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