Table of ContentsView AllTable of ContentsWhat It IsPurposeHow to PrepareWhat to ExpectRecovery
Table of ContentsView All
View All
Table of Contents
What It Is
Purpose
How to Prepare
What to Expect
Recovery
What Is a LEEP?
A LEEP is one of the most common procedures used to treatcervical dysplasia, which is when abnormal (precancerous) cells are found within or around a woman’s cervix.
This procedure takes around 20 minutes and is performed in your healthcare provider’s office underlocal anesthesia. However, some women may prefer to have general anesthesia, in which case it can be done in a hospital or surgery center.
After injecting a numbing medication into the cervix, the practitioner inserts a thin, wire loop into the vagina. Once it reaches the cervix, an electric current is passed through the wire loop to cut away and remove a thin layer of abnormal cervical tissue.
Besides a LEEP, other procedures that may be used to remove abnormal cervical cells include:
Your healthcare provider will decide on a LEEP or another procedure based on factors like your age, the location of the abnormal cells in your cervix, the size and number of areas affected, their suspicion for cancer, and whether you have undergone prior cervical treatments.
Contraindications
Severecervicitis(inflammation or infection of the cervix) is a contraindication to a LEEP.
A LEEP is also not performed during pregnancy unless there is a high suspicion of cervical invasive cancer.
Potential Risks
Risks associated with a LEEP include:
Purpose of a LEEP Procedure
A LEEP is typically done when a Pap smear or a colposcopy suggests the presence of abnormal cervical cells or cervical dysplasia.
While a LEEP can remove abnormal cervical cells, it is not a cure for HPV. Even if the cells are cleared, you will still have HPV and require ongoing monitoring to ensure that any abnormal cells are treated promptly if and when they emerge.
Less commonly, a LEEP may be used to help diagnose or treat the following conditions:
Causes and Risk Factors of Cancer
If your healthcare provider tells you that you need to undergo a LEEP, they will likely ask you to schedule the procedure when you are not menstruating. This will allow for optimal visualization of your cervix.
Once you are scheduled for a LEEP, your practitioner will give you instructions on how to prepare.
Location
What to Wear
You will need to undress from the waist down for your LEEP. As such, it’s a good idea to wear loose-fitting, comfortable clothes that are easy to remove on the day of your procedure.
Food and Drink
You do not need to abstain from food or drink prior to a LEEP unless you are getting sedating anesthesia. Your doctor’s office will let you know.
Medications
If you take aspirin, or another type of blood thinner, your healthcare provider might ask you to stop or decrease the dose before your LEEP.
Be sure to tell your practitioner all of the drugs you are taking, including prescription and over-the-counter medications, herbal products, vitamins, and recreational drugs.
Your healthcare provider may advise you to take four regular-strength Motrin (ibuprofen) tablets or two extra-strength Tylenol (acetaminophen) tablets one hour prior to a LEEP (assuming you are not allergic to these drugs). This can help ease the mild discomfort you may feel during the procedure.
What to Bring
Items to bring with you on the day of your LEEP include:
Pre-Op Lifestyle Changes
Your healthcare provider will advise you to not have sex, douche, or use tampons or any vaginal creams or medicines 24 hours before the procedure.
What to Expect on the Day of the Procedure
While a LEEP is a short procedure, it’s natural to feel uneasy about it. It may help you to know what to expect, from start to finish.
Verywell / JR Bee
Before the Procedure
Upon arrival at your healthcare provider’s office for a LEEP, you will be asked to use the bathroom to empty your bladder. In the exam room, you will then undress from the waist down and put on a gown.
During the Procedure
When it’s time to begin the procedure, you will be asked to get on the exam table, put your feet in the stirrups at its end, and lie on your back.
Your healthcare provider will then proceed with the following steps:
There will be slight variations in what occurs at each step if the procedure is done in a hospital or surgicenter, but the general process is the same.
After the Procedure
You may feel a deep, dull pain after the procedure due to the small wound created in the cervix. You will have some time to rest, use the restroom, and place a sanitary pad.
After you discuss any questions or concerns that you have about your procedure or recovery, you can leave your healthcare provider’s office.
After a LEEP, your healthcare provider will give you various instructions to follow at home.
These instructions generally include:
When to Call Your Healthcare ProviderCall your healthcare provider if you experience any of the following symptoms:Fever or chillsHeavy vaginal bleeding or bleeding with clotsFoul-smelling vaginal dischargeSevere abdominal pain
When to Call Your Healthcare Provider
Call your healthcare provider if you experience any of the following symptoms:Fever or chillsHeavy vaginal bleeding or bleeding with clotsFoul-smelling vaginal dischargeSevere abdominal pain
Call your healthcare provider if you experience any of the following symptoms:
Long-Term Care
You will have a follow-up appointment about two weeks after your LEEP to review the cervical tissue results from the laboratory.
Be sure to follow up with your healthcare provider about your results if you do not hear back from them/don’t already have this appointment scheduled. Don’t assume that no news is good news.
If the cervical dysplasia has been adequately treated (i.e., all of the abnormal cells have been removed), depending on your case, you can expect to undergo more frequent Pap smears andHPV testing.
The purpose of these tests is to ensure that the dysplasia does not return. If all the follow-up test results are normal, you may be able to return to screenings every three years.
If the margins are positive (meaning the edges of the tissue sample contain abnormal cells), the treatment and follow-up may vary. Sometimes a repeat procedure may be recommended.
Strategies for follow-up after a LEEP vary slightly among healthcare providers. That said, the overall goal of these tests is to maximize the prevention of cervical cancer while minimizing the harm of overtesting and overtreating.
Possible Future Procedures
If any of the follow-up tests show cervical dysplasia, a LEEP or other excisional or ablative procedure (for example, laser conization or cryosurgery, respectively) may be required. In some cases, if the abnormal cells persist, ahysterectomymay be recommended.
If cancer cells are ever found, imaging tests will be ordered to determine if and how far thecancer has spread. You will also be referred to an oncologist. Treatment of cervical cancer involves surgery, radiation, and/or chemotherapy.
Lifestyle Adjustments
The following lifestyle practices can help prevent cervical cancer:
Cervical Cancer
A Word From Verywell
Even though a LEEP is a safe, straightforward procedure that treats pre-cancerous cell changes on the cervix well, it’s normal to feel a bit nervous about having one done.
If your healthcare provider has recommended a LEEP, try to remain calm and focus your thoughts on how this procedure will help you stay healthy and cancer-free. Also, do not hesitate to ask your practitioner questions or relay any concerns you have.
11 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Sawaya GF, Smith-McCune K.Cervical Cancer Screening.Obstet Gynecol. 2016 Mar; 127(3): 459–467.doi:10.1097/AOG.0000000000001136Cooper DB, Carugno J, Menefee GW.Conization of Cervix. In:StatPearls[Internet]. Treasure Island (FL): StatPearls Publishing.Beharee N, Shi Z, Wu D, Wang J.Diagnosis and treatment of cervical cancer in pregnant women.Cancer Med. 2019 Sep; 8(12): 5425–5430. doi:10.1002/cam4.2435The American College of Obstetricians and Gynecologists.Loop Electrosurgical Excision Procedure (LEEP).Lieb JA, Mondal A, Lieb L, Fehm TN, Hampl M.Pregnancy outcome and risk of recurrence after tissue-preserving loop electrosurgical excision procedure (LEEP).Arch Gynecol Obstet.2023 Apr;307(4):1137-1143. doi:10.1007/s00404-022-06760-5Frega A, Lavini G, Guarino A, et al.Cervical carcinogenesis, bacterial vaginosis, HPV-mRNA test and relapse of CIN2+ after loop electrosurgical excision procedure (LEEP).Eur Rev Med Pharmacol Sci. 2017 May;21(10):2504-2511. PMID: 28617533Johns Hopkins Medicine.Loop Electrosurgical Excision Procedure (LEEP).Cleveland Clinic.Loop Electrosurgical Excision Procedure (LEEP).Perkins RB, Guido RS, Castle PE, et al.2019 ASCCP Risk-Based Management Consensus Guidelines for Abnormal Cervical Cancer Screening Tests and cancer Precursors.J Low Genit Tract Dis. 2020 Apr; 24(2): 102–131. doi:10.1097/LGT.0000000000000525The University of Michigan Medicine.Cone Biopsy (Conization) for Abnormal Cervical Cell Changes.American Cancer Society.Can Cervical Cancer Be Prevented?
11 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Sawaya GF, Smith-McCune K.Cervical Cancer Screening.Obstet Gynecol. 2016 Mar; 127(3): 459–467.doi:10.1097/AOG.0000000000001136Cooper DB, Carugno J, Menefee GW.Conization of Cervix. In:StatPearls[Internet]. Treasure Island (FL): StatPearls Publishing.Beharee N, Shi Z, Wu D, Wang J.Diagnosis and treatment of cervical cancer in pregnant women.Cancer Med. 2019 Sep; 8(12): 5425–5430. doi:10.1002/cam4.2435The American College of Obstetricians and Gynecologists.Loop Electrosurgical Excision Procedure (LEEP).Lieb JA, Mondal A, Lieb L, Fehm TN, Hampl M.Pregnancy outcome and risk of recurrence after tissue-preserving loop electrosurgical excision procedure (LEEP).Arch Gynecol Obstet.2023 Apr;307(4):1137-1143. doi:10.1007/s00404-022-06760-5Frega A, Lavini G, Guarino A, et al.Cervical carcinogenesis, bacterial vaginosis, HPV-mRNA test and relapse of CIN2+ after loop electrosurgical excision procedure (LEEP).Eur Rev Med Pharmacol Sci. 2017 May;21(10):2504-2511. PMID: 28617533Johns Hopkins Medicine.Loop Electrosurgical Excision Procedure (LEEP).Cleveland Clinic.Loop Electrosurgical Excision Procedure (LEEP).Perkins RB, Guido RS, Castle PE, et al.2019 ASCCP Risk-Based Management Consensus Guidelines for Abnormal Cervical Cancer Screening Tests and cancer Precursors.J Low Genit Tract Dis. 2020 Apr; 24(2): 102–131. doi:10.1097/LGT.0000000000000525The University of Michigan Medicine.Cone Biopsy (Conization) for Abnormal Cervical Cell Changes.American Cancer Society.Can Cervical Cancer Be Prevented?
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Sawaya GF, Smith-McCune K.Cervical Cancer Screening.Obstet Gynecol. 2016 Mar; 127(3): 459–467.doi:10.1097/AOG.0000000000001136Cooper DB, Carugno J, Menefee GW.Conization of Cervix. In:StatPearls[Internet]. Treasure Island (FL): StatPearls Publishing.Beharee N, Shi Z, Wu D, Wang J.Diagnosis and treatment of cervical cancer in pregnant women.Cancer Med. 2019 Sep; 8(12): 5425–5430. doi:10.1002/cam4.2435The American College of Obstetricians and Gynecologists.Loop Electrosurgical Excision Procedure (LEEP).Lieb JA, Mondal A, Lieb L, Fehm TN, Hampl M.Pregnancy outcome and risk of recurrence after tissue-preserving loop electrosurgical excision procedure (LEEP).Arch Gynecol Obstet.2023 Apr;307(4):1137-1143. doi:10.1007/s00404-022-06760-5Frega A, Lavini G, Guarino A, et al.Cervical carcinogenesis, bacterial vaginosis, HPV-mRNA test and relapse of CIN2+ after loop electrosurgical excision procedure (LEEP).Eur Rev Med Pharmacol Sci. 2017 May;21(10):2504-2511. PMID: 28617533Johns Hopkins Medicine.Loop Electrosurgical Excision Procedure (LEEP).Cleveland Clinic.Loop Electrosurgical Excision Procedure (LEEP).Perkins RB, Guido RS, Castle PE, et al.2019 ASCCP Risk-Based Management Consensus Guidelines for Abnormal Cervical Cancer Screening Tests and cancer Precursors.J Low Genit Tract Dis. 2020 Apr; 24(2): 102–131. doi:10.1097/LGT.0000000000000525The University of Michigan Medicine.Cone Biopsy (Conization) for Abnormal Cervical Cell Changes.American Cancer Society.Can Cervical Cancer Be Prevented?
Sawaya GF, Smith-McCune K.Cervical Cancer Screening.Obstet Gynecol. 2016 Mar; 127(3): 459–467.doi:10.1097/AOG.0000000000001136
Cooper DB, Carugno J, Menefee GW.Conization of Cervix. In:StatPearls[Internet]. Treasure Island (FL): StatPearls Publishing.
Beharee N, Shi Z, Wu D, Wang J.Diagnosis and treatment of cervical cancer in pregnant women.Cancer Med. 2019 Sep; 8(12): 5425–5430. doi:10.1002/cam4.2435
The American College of Obstetricians and Gynecologists.Loop Electrosurgical Excision Procedure (LEEP).
Lieb JA, Mondal A, Lieb L, Fehm TN, Hampl M.Pregnancy outcome and risk of recurrence after tissue-preserving loop electrosurgical excision procedure (LEEP).Arch Gynecol Obstet.2023 Apr;307(4):1137-1143. doi:10.1007/s00404-022-06760-5
Frega A, Lavini G, Guarino A, et al.Cervical carcinogenesis, bacterial vaginosis, HPV-mRNA test and relapse of CIN2+ after loop electrosurgical excision procedure (LEEP).Eur Rev Med Pharmacol Sci. 2017 May;21(10):2504-2511. PMID: 28617533
Johns Hopkins Medicine.Loop Electrosurgical Excision Procedure (LEEP).
Cleveland Clinic.Loop Electrosurgical Excision Procedure (LEEP).
Perkins RB, Guido RS, Castle PE, et al.2019 ASCCP Risk-Based Management Consensus Guidelines for Abnormal Cervical Cancer Screening Tests and cancer Precursors.J Low Genit Tract Dis. 2020 Apr; 24(2): 102–131. doi:10.1097/LGT.0000000000000525
The University of Michigan Medicine.Cone Biopsy (Conization) for Abnormal Cervical Cell Changes.
American Cancer Society.Can Cervical Cancer Be Prevented?
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