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LEEP

If you receive an abnormal colposcopy result, your health care provider may recommend that you have a loop electrosurgical excision procedure, commonly referred to as LEEP.

What is a LEEP?

A LEEP involves removing abnormal tissue from your cervix using a thin wire loop. It is usually done within eight weeks of diagnosis. Over 90% of women will only require one LEEP to remove any abnormal tissue.

What happens during a LEEP?

  1. The doctor will take a look at your cervix using a special microscope called a colposcope.
  2. A small amount of vinegar or iodine will be placed on your cervix to make any abnormalities more visible.
  3. Local freezing is then used to numb the cervix. which is normal. Some people feel a pinch or cramp when the freezing is done. The freezing medication will make your heart beat a little faster, but it’s not dangerous, and it will pass within a few minutes.
  4. A thin wire loop is then used to remove abnormal tissue. The procedure usually lasts less than five minutes.
  5. To reduce any bleeding, a brown paste may be placed on the cervix. The paste comes out later looking brown or black, which is normal.

What happens after my LEEP?

Most women have no symptoms after a LEEP. If you have cramps, you can use pain medication such as plain acetaminophen (Tylenol®) or ibuprofen (Advil®) for pain relief. You may experience cramps, light vaginal bleeding or watery vaginal discharge for a few weeks. Avoid using tampons, swimming, taking baths, or having sexual intercourse for three weeks.

Also, avoid any heavy lifting or strenuous exercise for one week. Your doctor will review your results with you within three weeks of the procedure. Please contact your doctor if you haven’t heard from them. Usually, a follow-up appointment will be recommended six months after your LEEP.


Watch this video to see what happens during a LEEP procedure:

 


Risks

There is a small possibility of heavy bleeding or an infection after a LEEP. Please contact your doctor immediately if you notice any of the following: increased pelvic pain, heavy or prolonged bleeding, fever, or smelly vaginal discharge. 


Based on recent studies, your ability to get pregnant is not affected by a LEEP. It may slightly increase the likelihood of pregnancy complications such as miscarriage and delivering your baby prior to full term. Please speak with your doctor to address any concerns. 


In rare cases a LEEP may cause the entrance of your cervix to narrow, also known as cervical stenosis.

Please advise your doctor if you’re pregnant. In many cases, the LEEP can be performed after your baby is born.

Your Follow-Up Appointment

Usually you will have a follow-up colposcopy six months after your LEEP. The doctor will take a small tissue sample (biopsy) and will do a test to check for HPV. The HPV test will feel similar to a Pap test. 

The HPV test is used to determine if more follow-up is required, or if you can return to regular Pap test screening with your health care provider.
You are at a very low risk for recurring abnormalities if your biopsy and HPV test results are normal. You should continue to see your primary health care provider for cervical screening (Pap test).
A second LEEP is required if the biopsy taken at your follow up appointment shows high grade cell changes of the cervix. You will continue to be monitored by the colposcopy clinic if you have an abnormal HPV test result but a normal biopsy result.
 

LEEP and HPV

LEEP may remove cells in your cervix containing human papillomavirus (HPV). In addition, HPV infections may be cleared by the body’s immune system. You will be tested for HPV after your LEEP.

Women with a normal HPV test after LEEP have a very low risk of having further high-grade cell changes (cervical intraepithelial neoplasia grade 2 or 3) in the near future. Women with an abnormal HPV test are at a higher risk of recurring high-grade cell changes and closer follow-up is needed.
While most couples share the same HPV types, it is possible to get infected again through sexual contact.
 
Yes, even if you’ve already had HPV-related diseases, the HPV vaccine is still recommended. It will protect you from types of HPV you haven't been exposed to and decrease your chance of future HPV related diseases. Past HPV infections don't necessarily protect you from future infection even if it is the same type.
 











A LEEP is usually done within eight weeks of a diagnosis.

Over 90% of women will only require one LEEP.

 

There is a small possibility of heavy bleeding or an infection after a LEEP procedure. Please contact your doctor immediately if you notice any of the following: increased pelvic pain, heavy or prolonged bleeding, fever, or smelly vaginal discharge.

A LEEP procedure may cause the entrance of your cervix to narrow, also known as cervical stenosis, and can slightly increase your chances of delivering a baby prior to its due date.


  1. The doctor will take a look at your cervix using a special microscope called a colposcope.
  2. A small amount of vinegar or iodine will be placed on your cervix to make any abnormalities more visible.

  3. Local freezing is then used to numb the cervix. Some people feel a pinch or cramp when the freezing is done. The freezing medication will make your heart beat a little faster, but its not dangerous, and should pass within a few minutes.

  4. An electric current passes through a thin wire loop and the wire loop is then used to remove abnormal tissue. The procedure should last less than five minutes.

  5. To reduce any bleeding, a brown paste may be placed on the cervix. The paste comes out later looking brown or black, which is normal.
Most women have no symptoms after a LEEP. If you have cramps, you can use pain medication such as plain acetaminophen (Tylenol®) or ibuprofen
(Advil®) for pain relief. You may experience cramps, light vaginal bleeding or watery vaginal discharge for a few weeks.

Avoid using tampons, swimming, taking baths, or having sexual intercourse for three weeks. Also, avoid any heavy lifting or strenuous exercise for one week. Your doctor will review your results with you within 3 weeks of the procedure. Usually, a follow-up appointment will be recommended 6 months after your LEEP.

Your doctor will follow up with you six months after your LEEP to re-examine your cervix using a colposcope. Often, the doctor will take a small tissue sample (biopsy), and perform a cervical HPV test. 


The HPV test is used to determine if more follow-up is required, or if you can return to regular Pap test screening with your health care provider.
You are at a very low risk for recurring abnormalities if you receive negative results from your biopsy and HPV test. You should continue to see your primary health care provider for regular cervical screening
(Pap test). Your first Pap test should be one year after you were discharged from colposcopy. 

A second LEEP is required if the biopsy taken at your follow up appointment shows high grade cell changes of the cervix. You will continue to be monitored by the colposcopy clinic if you have a positive HPV test results but a negative biopsy result.

Based on recent studies, your ability to get pregnant is not affected by a LEEP. It may slightly increase the likelihood of pregnancy complications such as miscarriage and delivering your baby prior to full term. Please speak with your doctor to address any concerns.

Please advise your doctor if you’re pregnant. In many cases, the LEEP can be performed after your baby is born.

LEEP and HPV

LEEP does not remove human papillomavirus (HPV) but HPV infections are often cleared by the body’s immune system. You will be tested for HPV after your LEEP. Women with a negative HPV test after LEEP have a very low risk of having further high-grade cell changes (CIN2 or CIN3) in the near future. Women with a positive HPV test are at a higher risk of recurring high-grade cell changes.
While most couples share the same HPV types, it is possible to get infected again through sexual contact. More studies are underway to better answer this question.
 
Yes, even if you’ve already had HPV-related diseases, the HPV vaccine is still recommended. It will protect you from types of HPV you haven't
been exposed to and decrease your chance of future HPV related diseases.

Past HPV infections don't necessarily protect you from future infection even if it was the same type. 


SOURCE: LEEP ( )
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