leep procedure

LEEP Procedure – Need, Preparation, Procedure, Cost, Recovery process

LEEP is the procedure that removes abnormal cells from the cervix. It stands for the Loop Electrosurgical Excision Procedure. Your doctor uses a small wire loop, which acts as a surgical knife when electrical current passes through it. As the current charges the wire, it becomes hot and can aid in scrapping the abnormal cells. Read ahead to know more about the procedure, the risks associated with it, and the preparation involved in it.

Need For LEEP Procedure

LEEP It is a procedure recommended for women when the doctor observes abnormality in the cervix during a routine pelvic examination. It is also recommended by the doctor when your pap tests return abnormal results. In most of the cases, the abnormal cells developing in the cervix can cause serious complications over time. Polyps benign growths) or precancerous cells can appear as abnormal cells in the cervix. So, without treatment, it can develop into cervical cancer. Removing the abnormal cells and sending them to the lab will help determine if they can cause harm to your health. Based on the results, your doctor can suggest treatment.

Loop Electrosurgical Excision Procedure is also used to diagnose and treat genital warts. Warts develop in the cervix due to the presence of human papillomavirus (HPV). The presence of HPV can increase the chances of developing cervical cancer. It is not advisable to use the procedure when you suffer from acute cervix inflammation or pelvic inflammatory disease. Then, your doctor can suggest a cone biopsy. It is the surgical choice, which can offer better results. Another procedure is cryotherapy, which freezes the abnormal area. It dies and ultimately falls off.

Cost Of LEEP Procedure

In countries like the USA, opting for a LEEP procedure can cost around $3,000 to $9,000. Based on the severity, the hospital you opt, and the doctor’s fees. The price can come down by having an insurance card. In countries like India, you can find the rates going down.

Complications Associated With LEEP

While LEEP is a safe and effective procedure, it still carries a small amount of risk. While the majority of the women undergoing the procedure may not experience a problem, some can face problems. Rare problems include the following:

Cervix Infection

Cervix Infection

After the procedure, some women can face the risk of inflammation or irritation of the cervix. The condition can trigger several signs like itching, pain during intercourse or foul vaginal discharge. In such cases, you need to see a doctor immediately.

Bleeding

Some women can experience heavy bleeding after the procedure. It can occur due to injuries or damage to the surrounding blood vessels. But, the expert doctor uses sophisticated tools to seal the surrounding blood vessels to prevent the risk.

Scarring Of Cervix

Since LEEP is an excisional procedure, you face the risk of losing cervical tissue. It can lead to the scarring of the cervix. But, the severity depends on the extent of tissues removed by the doctor during the procedure.

Trouble Getting Pregnant

You will find it difficult to get pregnant in the same year after undergoing the procedure. It is because you face the small risk of narrowing of the cervix. The condition is medically known as cervical stenosis. Due to the procedure, your cervix becomes tightly closed. So, it becomes difficult for the sperm to get in and fuse with the egg. It reduces your possibility of getting pregnant naturally. If a woman does not have periods after the procedure, then she suffers from cervical stenosis

Cervical Incompetence

Some women who undergo the procedure can experience cervical incompetence. It means that the cervix cannot remain closed during pregnancy. It can result in miscarriage or women in advanced pregnancy face the risk of preterm labor. To avoid such issues, your gynecologist can suggest cervical cerclage. It is the procedure used to sew the incompetent cervix during the pregnancy. It ensures the cervix remains closed during the pregnancy. So, it avoids the risk of miscarriage and preterm delivery. But, not all women require cervical cerclage.

Risk Of Caesarean

Women who undergo the procedure face the risk of C-section when they fall pregnant. It is because the cervical scarring caused by the procedure makes it difficult for the cervix to dilate normally. So, your doctor can use the invasive procedure to stretch the cervix opening or choose cesarean for delivering the baby safely.

Emotional Changes

Many doctors fail to inform the patients regarding the emotional changes occurring after the procedure. A portion of women undergoing the procedure can suffer from emotional aftermath apart from the physical side effects of the procedure. So, women can face the following:

  • Severe mood swings
  • Fear of physical intimacy
  • Breaking down for no apparent reasons

The emotional changes can affect the dynamics of an intimate relationship. A woman in a committed relationship needs to consult their doctor to discuss the changes in detail. Your partner needs to understand the emotional changes you undergo. Women who have a history of mental or physical abuse can experience more intense side effects of the procedure. Take time to inform your loved ones about the problem you experience. Also, find the therapies or alternative options to manage the issues you face.

Sexual Dysfunction

Some women who undergo the loop electrosurgical excision can experience sexual side effects due to the problem. The problems include:

  • Reduced vaginal sensation
  • A loss of sex drive
  • Loss of ability to climax (orgasm)
  • Pain during sexual intercourse

Women who undergo the procedure need to consult their gynecologist to gain information about the risks associated with it. Never go through a procedure without knowing the complete details.

Preparing For LEEP Procedure

Before the loop electrosurgical excision procedure, you need some preparation. So, you have to follow the pointers suggested below:

Fix A Date

You need to schedule the procedure after your monthly cycle. When you are still menstruating, it becomes impossible to see the cervix region. So, schedule the procedure the week after your menstruation ends. It allows the doctor to monitor the cervix clearly and detect any bleeding caused due to the procedure.

Detect Pregnancy

If you have a partner or in a committed relationship, then it is better to take a pregnancy test before the procedure. It is not advisable to undergo the procedure during pregnancy. So, inform your doctor if you suspect pregnancy.

Make A Pre-Op Appointment

You need to make a pre-op appointment with the doctor to ensure you are healthy. The doctor can perform a physical assessment to ensure you are fine. Then, you need to make an appointment with the anesthesiologist. Since the procedure uses anesthesia to numb pain and makes you sleep, you need to see the doctor for an assessment. It is to detect the right amount of sedation needed for the procedure. In case you need to test blood for the procedure, then you need to provide a sample at least three days before the scheduled procedure. The doctor can confirm the date of the procedure only after getting all clear.

Stop Medications

You need to stop certain medications before the procedure. So, you need to talk to your doctor during the pre-op appointment. In most cases, your doctor suggests stopping any medication containing aspirin at least five to seven days before the surgery. Follow the instructions provided by the doctor. Certain NSAIDs (nonsteroidal anti-inflammatory drugs) and aspirin can increase the risk of bleeding during the procedure.

Quit Smoking

Using tobacco products can affect the procedure as well as recovery. Since smokers have difficulty breathing properly during the procedure, it is advisable to stop the habit. It also causes slow healing of your cervix. Therefore, quit before the procedure to ensure good results.

Avoid Sex And Douching

You need to avoid sexual intercourse and douching forty-eight hours before the procedure.

Plan Ahead

Since you cannot drive alone after the procedure, make arrangements for someone to come with you. The sedation provided during the procedure can make you drowsy. So, it is not advisable to travel alone or use public transport. Ask your friend or family member to take you home. Bring a menstrual pad during the appointment. You can experience bleeding after the procedure. So, you have to come prepared.

If you cannot attend the pre-op appointment, then call your doctor to get detailed instructions you have to follow.

Before LEEP Procedure

In most cases, the procedure is performed in the hospital or at the doctor’s office. The procedure takes only ten minutes. But, it requires thirty minutes to complete the entire procedure. Here are a few things you need to know before the procedure:

Prepare At Home

You need to shower at home before reaching the hospital. You must avoid using makeup, deodorant, lotion, powder or antiperspirant on the day of the procedure. Remove your jewelry and piercing.

Food And Drinks

You can eat and drink before the procedure. Unlike other surgical procedures, you never have to stop eating food or drinking fluids before the procedure.

Instructions At Pre-Op

Once you reach the hospital, you need to sign the necessary paperwork. The doctor or health care team will explain the procedure after showing the equipment. You can ask your doubts or raise any concerns regarding the procedure.

After agreeing to the procedure, you can change into a hospital gown. Use the restroom if necessary as it is the last time you can use it.

During LEEP Procedure

When it is time to begin the procedure, you need to lie on the table in the same position as for a pelvic examination. So, you need to lay on the back with your feet in stirrups.

The nursing staff will place compression stocking on your legs. It is to prevent leg clots in the legs during the procedure. In some cases. A doctor can provide Heparin (a blood-thinning medication) is you face a high risk of blood clots. The nursing staff also places grounding pads on the thighs. It is to avoid electrical shocks from affecting your body.

During LEEP Procedure

Before beginning the actual procedure, the doctor inserts a speculum into the vagina. It is to see the spread of the vaginal walls and see the cervix. The doctor can also use a special device called a colposcope to magnify the cervix tissue.

Colposcope
Colposcope

Then, the doctor can perform the following to remove the abnormal cells from your cervix.

Spot Abnormal Cells

Your doctor applies a vinegar solution on your clean cervix. It is the process to spot abnormal cells. The vinegar solution turns the abnormal cells to white. So, it becomes easier to spot such cells. Your doctor can use iodine instead of vinegar. Iodine can transform the color of your cervix. So, it stains the normal cells brown. It becomes easier to detect abnormal cells.

Remove Abnormal Cells

The doctor injects a local anesthetic to numb the cervix before starting the procedure. The anesthetic is decided based on your condition. Once the cervix is numb, your doctor passes the electrical cautery wire loop. It is passed through the speculum. Then, the abnormal tissue is removed by scraping. The loop can scrape abnormal tissue in a single piece. It also aids in sealing any bleeding blood vessels. During the procedure, you can experience slight cramping or pressure. If you feel pain or feel faint during the procedure, inform your doctor immediately. The doctor can apply more anesthetic to reduce discomfort.

Stop Pain

After removing the abnormal cells and sending them to the lab, the doctor applies a paste-like medication on your cervix. It is to reduce the chances of bleeding.

After LEEP Procedure

After the procedure, you need to spend at least thirty minutes to an hour at the hospital. It is to check for any complications associated with the procedure. During the time, your doctor also discusses the next steps you need to take after LEEP. Your doctor also sheds light on what to expect from the recovery process. You can go home after a few hours after completing the procedure. You must avoid traveling home alone. So, ask someone to drive you home afterward.

The tissue collected from the cervix during the procedure is checked by the pathologist in the lab. It is checked under the microscope for the presence of abnormal cells. You can get the results from your doctor ten days or sooner after the procedure.

Recovering From LEEP Procedure

While you are recovering from the LEEP procedure, you need to follow the instructions provided by the doctor. So, you need to follow the suggestions like:

Use Sanitary Napkin

It is normal to experience vaginal discharge after the procedure. Therefore, you need to wear a sanitary napkin to absorb the discharge. The discharge may have the following characteristics:

  • A watery discharge
  • Brown, black or pink discharge

The brown or black discharge occurs due to the paste used on your cervix to spot the abnormal cells. You can also expect mild cramping due to the procedure.

Delayed/Heavier Periods

Your menstruation after the procedure can get delayed. In some cases, women can experience heavier than normal bleeding during the period.

Avoid Vaginal Insertion

While recovering from the procedure, try to avoid any products that you need to insert in the vagina for at least four weeks. Therefore, avoid the following”

  • Menstrual cups
  • Tampons

Refrain from vaginal intercourse or penetration after the procedure. You need to consult your doctor to get all clear.

 Refrain From Strenuous Activities

It is better to avoid any strenuous activities until your cervix heals. Therefore, refrain from heavy lifting, physically demanding work or exercises.

Take Painkillers

You can feel mild discomfort due to the procedure. So, you can take over-the-counter pain medication like acetaminophen to ease the discomfort. But, you need to avoid NSAIDs as it can trigger complications. Therefore, avoid taking aspirin until your doctor suggests it is safe.

Call Your Doctor

After the procedure, you can face discomfort. It is a normal occurrence. But, certain signs indicate you have developed an infection or other problems. So, you need to call your doctor immediately after you experience the following:

  • Heavy bleeding in the weeks after the procedure
  • Severe abdominal pain
  • Fever (when your body temperature is 101 degrees Fahrenheit or higher)
  • Smelly vaginal discharge
  • Chills
  • Bleeding with clots

These signs indicate you have some serious underlying problems. Therefore, you need to see the doctor immediately to get medical treatment. Prompt medical attention can stop the problem from escalating.

Follow-Up Visit

You need to schedule follow-up visits with a healthcare professional. Regular cervical cancer screening is necessary to make sure of the absence of abnormal cells. It can also detect any recurrence of abnormal cells. If the screening tests show abnormal cells, then you need more treatment. You can protect the health of your cervix with a regular pelvic examination. Make an appointment for cervical cancer screening to detect any issues early.

Ensure Good Cervical Health

After the procedure, you need to make sure your cervix stays healthy. So, you need to follow the guidelines suggested below:

  • Stop smoking as it can increase your chance of developing cancer in the cervix.
  • Reduce the risk of sexually transmitted infections by practicing safe sex. Limit your number of sexual partners and ensure they have no STIs or STDs. Use a condom to reduce the risk associated with such infections.

Does LEEP Procedure Work?

If your doctor detects abnormal cells in the cervix, then the LEEP procedure can work very well. It can treat abnormal cell changes. If your doctor removes all the abnormal tissue, then you may need no further surgery. It is observed that the doctors successfully remove all the abnormal tissue in all cases. But, you also face the risk of developing abnormal cells in the future. But, the procedure as several benefits. It helps detect and remove precancerous cells. The procedure helps prevent cancer. It also aids your health care provider to make a better diagnosis. Therefore, your doctor can develop a better treatment plan for your problem. It is a simple procedure that you can undergo without any hassles or complications.

Conclusion

LEEP is an effective procedure to detect vaginal or cervical problems. If your doctor suspects abnormalities during a pelvic exam after getting the results of a pap test, then the procedure can conclusively determine any issues. It is also helpful in detecting precancerous cells that can escalate into a serious complication. So, the procedure can help prevent the development of deadly problems like cervical cancer. But, before undergoing the procedure, try to learn more about the pros and cons associated with it. Decide after careful analysis of the facts to ensure you suffer no complications.

View Article Sources
  • https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/loop-electrosurgical-excision-procedure-leep
  • https://www.plannedparenthood.org/learn/cancer/cervical-cancer/whats-leep
  • https://www.acog.org/Patients/FAQs/Loop-Electrosurgical-Excision-Procedure-LEEP?IsMobileSet=false

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