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
- Chronic disease such as diabetes or obesity
- Menstruation at the time of the procedure—It is best to have LEEP done when you do not have your period.
- History of pelvic inflammatory disease
- Inflammation of the cervix
- Pregnancy or possible pregnancy
What to Expect
Prior to Procedure
- 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?
- Washing their hands
- Wearing gloves or masks
- Keeping your incisions covered
- Washing your hands often and reminding visitors and healthcare providers to do the same
- Reminding your healthcare providers to wear gloves or masks
- Not allowing others to touch your incisions
- 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 Congress of Obstetricians and Gynecologists http://www.acog.org
Family Doctor—American Academy of Family Physicians http://familydoctor.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.
Loop electrosurgical excision procedure (LEEP). American Congress of Obstetricians and Gynecologists website. Available at: http://www.acog.org/Patients/FAQs/Loop-Electrosurgical-Excision-Procedure-LEEP. Updated July 2014. Accessed August 15, 2014.
Loop electrosurgical excision procedure (LEEP). American Society for Colposcopy and Cervical Pathology website. Available at: http://www.asccp.org/Education/COURSES-Comprehensive-Colposcopy-HRA-Advanced-and-more/Loop-Electrosurgical-Excision-Procedure-LEEP. Accessed August 15, 2014.
Neff D. Endometrial ablation. EBSCO Health Library website. Available at: http://www.ebscohost.com/healthLibrary. Updated January 28, 2014. Accessed August 15, 2014.
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.
- Reviewer: Andrea Chisholm, MD
- Review Date: 08/2014 -
- Update Date: 00/12/2014 -