Loop Electrosurgical Excision Procedure (LEEP)
What is a loop electrosurgical excision procedure (LEEP)?
Loop electrosurgical excision procedure (LEEP) uses a wire loop heated by electric
current. It is used to remove cells and tissue in a woman’s lower genital tract. It
is used as part of the diagnosis and treatment for areas that are abnormal or cancer.
The lower genital tract includes the cervix and vagina. The cervix is the lower, narrow
part of the uterus. The vagina connects the cervix and the vulva.
With LEEP, an electric current passes through the fine wire loop. It is then used
to cut away a thin layer of abnormal tissue. This tissue will be sent to the lab for
testing. LEEP can also remove abnormal cells to let healthy tissue grow.
Why might I need a LEEP?
LEEP may be done when cervical or vaginal problems are found during a pelvic exam.
Or it may be done if abnormal cells are found during a Pap test. LEEP is also done
to find cancer of the cervix or vagina.
Cells that appear to be abnormal, but are not yet cancer, may be called precancer.
These abnormal cells may be the first sign that cancer could grow years later.
LEEP may also be used to help in the diagnosis or treatment of:
Polyps (benign growths)
Genital warts, which may mean an infection with human papillomavirus (HPV), a risk
factor for cervical cancer
Diethylstilbestrol (DES) exposure in women whose mothers took DES in pregnancy, as
DES increases the risk for cancer of the reproductive system
Your healthcare provider may have other reasons to advise LEEP.
What are the risks of a LEEP?
Some possible complications may include:
If you are allergic to or sensitive to medicines, iodine, or latex, tell your healthcare provider.
If you are pregnant or think you could be, tell your healthcare provider.
There may be other risks depending on your condition. Be sure to talk about your concerns
with your healthcare provider before the procedure.
Some things may cause problems with LEEP. These include:
How do I get ready for a LEEP?
Your healthcare provider will explain the procedure and you can ask questions.
You will be asked to sign a consent form. This gives your permission to do the procedure.
Read the form carefully. Ask questions if something is not clear.
If you are pregnant or think you may be, tell your healthcare provider.
Tell your healthcare provider if you are sensitive to or are allergic to any medicines,
latex, tape, iodine, or anesthesia.
Tell your healthcare provider about all medicines (prescribed and over-the-counter)
and herbal supplements that you are taking.
Tell your healthcare provider if you have a history of bleeding disorders. Tell him
or her if you are taking any blood-thinning medicines (anticoagulants), aspirin, or
other medicines that affect blood clotting. You may be told to stop these medicines
before the procedure.
Don't use tampons, vaginal creams or medicine, or douche before the procedure.
Talk to your healthcare provider if you are considering having sex before the procedure.
LEEP is usually done when you are not having your menstrual period. Tell your healthcare
provider if your period has started.
Your healthcare provider may advise that you take a pain reliever 30 minutes before
You may want to bring a sanitary pad to wear home after the procedure.
Follow any other instructions your provider gives you to get ready.
What happens during a LEEP?
LEEP may be done in a healthcare provider’s office, on an outpatient basis, or as
part of your stay in a hospital. Procedures may vary depending on your condition and
your healthcare provider’s practices.
Generally, LEEP follows this process:
You will be asked to undress fully or from the waist down and put on a hospital gown.
You will be told to empty your bladder before the procedure.
You will lie on an exam table, with your feet and legs supported as for a pelvic exam.
Your healthcare provider will insert a tool called a speculum into your vagina to
spread the walls of the vagina apart to show the cervix.
Often, the healthcare provider will use a colposcope, a tool with a special lens like
a microscope, to magnify the tissues. The colposcope will be placed at the opening
of your vagina, but it does not enter your vagina.
Your healthcare provider will look through the colposcope to locate any areas for
treatment on the cervix or in the vagina. Photographs with the colposcope or sketches
of the areas on your cervix may be made for your healthcare record.
Your cervix may be cleaned and soaked with a vinegar solution, also called acetic
acid solution. This helps make the abnormal tissues turn white and become more visible.
You may have a mild burning feeling. An iodine solution is sometimes used to coat
the cervix, called the Schiller test.
The healthcare provider will numb the area using a small needle to inject medicine.
A type of forceps, called a tenaculum, may be used to hold the cervix steady for the
procedure. You may feel some cramping when the tenaculum is applied.
You will hear humming and/or blowing sounds from the equipment.
The LEEP wire will be inserted through the speculum and passed through the abnormal
tissues. This may take 1 or more passes. You may feel pressure or a slight cramping.
Some women feel faint during the procedure. Tell your healthcare provider or the nurse
if you have this feeling.
It is very important that you lie still during the procedure.
The amount and location of tissue removed depends on if LEEP is being used as a diagnostic
tool, or to remove abnormal tissue. LEEP wires come in different sizes and shapes.
The electrical current will seal the blood vessels, so usually there is very little
bleeding. Any bleeding from the LEEP site may be treated with a paste-like topical
The tissue will be sent to a lab for testing.
What happens after a LEEP?
After LEEP, you may rest for a few minutes after the procedure before going home.
You may want to wear a sanitary pad for bleeding. It is normal to have some mild cramping,
spotting, and dark or dark-colored discharge for several days. The dark discharge
is from the medicine applied to your cervix to control bleeding.
You may be instructed not to douche, use tampons, or have sex for 4-6 weeks after
LEEP, until your post-operative appointment or for a period of time advised by your
You may also have other limits on your activity, including no strenuous activity or
Take a pain reliever for cramping or soreness as directed by your healthcare provider.
Aspirin or some other pain medicines may increase the chance of bleeding. Be sure
to take only approved medicines.
Your healthcare provider will tell you when to return for further treatment or care.
Generally, women who have had LEEP will need Pap tests more often.
Tell your healthcare provider if you have any of these:
Your healthcare provider may give you other instructions after the procedure, depending
on your particular situation.
Before you agree to the test or the procedure make sure you know:
The name of the test or procedure
The reason you are having the test or procedure
What results to expect and what they mean
The risks and benefits of the test or procedure
What the possible side effects or complications are
When and where you are to have the test or procedure
Who will do the test or procedure and what that person’s qualifications are
What would happen if you did not have the test or procedure
Any alternative tests or procedures to think about
When and how will you get the results
Who to call after the test or procedure if you have questions or problems
How much will you have to pay for the test or procedure