McKesson Clinical Reference Systems: Women's Health Advisor 2002.2
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After reading this information, you will know what LEEP, also called LLETZ, is and when it is used. You will find out what the procedure involves and how to take care of yourself after the procedure.

What is LEEP/LLETZ?

LEEP is an abbreviation for loop electrosurgical excision procedure. It is also referred to as large loop excision of the transformation zone, or LLETZ.

LEEP is done to treat cervical dysplasia. Cervical dysplasia (also called cervical intraepithelial neoplasia) is abnormal tissue growth in the cervix. The cervix is the narrow, lower portion of the uterus. The uterus is the muscular organ at the top of the vagina. Babies develop in the uterus, and menstrual blood comes from the uterus.

Cervical dysplasia is most frequently discovered from a Pap smear, a test which most women should have every year. Several types of cervical dysplasia can progress to cervical cancer if not treated.

In the LEEP procedure, a wire loop is used to remove the abnormal tissue from your cervix. This procedure allows your health care provider to locate and remove the cervical dysplasia in one outpatient appointment. It saves the step of taking a sample piece of tissue (a biopsy) before removing the abnormal tissue with a laser or freezing it, which are other ways of treating cervical dysplasia. It may also be done instead of a surgical cone procedure. (A surgical cone procedure must be done in a hospital with a general anesthetic.)

What happens during the procedure?

This procedure is done when you are not having your menstrual period.

You lie on a treatment table and put your feet in stirrups, just as you would for a pelvic exam. Your health care provider then looks at your vagina and cervix through a colposcope, which is like a magnifying glass. Once your provider sees the area where the dysplasia is, he or she numbs that part of the cervix with a local anesthetic. Your provider then removes the abnormal tissue with a thin wire loop that is connected to an electrical unit. The loop is used to scoop out the abnormal tissue in one piece and to seal any bleeding blood vessels. A medicated paste is then put on the cervix to stop any bleeding. The only sensation you may feel is a slight tingling. The procedure takes only about 5 minutes.

The removed tissue is sent to a lab for testing.

What happens after the procedure?

You may have some minor bleeding or spotting the first day or so after the procedure. For 2 weeks after the procedure you will have a brownish discharge. This is a normal part of the healing of your cervix. Your cervix should heal completely within a month.

You should avoid heavy lifting, tampons, douching, and sexual intercourse for 4 weeks after the procedure.

See your health care provider for follow-up visits and Pap smears as recommended.

What are the risks of this procedure?

• You may have heavy bleeding.
• Rarely the cervix may become infected. Infection may cause the opening in your cervix to become narrower. The narrowing might make it more difficult for you to get pregnant.
• Sometimes the healing of the area from which the tissue was removed may cause the cervical opening to become narrower. The narrowing might make it more difficult for you to get pregnant.
• The tissue of the cervix may be weakened. This is called an incompetent cervix and it could cause a premature birth of a baby if you become pregnant.

When should I call my health care provider?

Call your health care provider if:

• You have any discharge from your vagina that has a bad odor.
• You have a fever.
• You have severe abdominal pain.
• You have bleeding that lasts more than 1 week.

This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.