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Loop Electrosurgical Excision Procedure (LEEP)

Loop electrosurgical excision procedure (LEEP) uses a wire loop heated by electric current is used to remove cells and tissue as part of the diagnosis and treatment for abnormal or cancerous conditions in lower female genital tract. Abnormal cell growth on the surface of the cervix is called cervical dysplasia. Though cervical dysplasia is not cancer, over time it can worsen and lead to cancer. This tissue will be sent to the lab for examination. LEEP can also remove abnormal cells to allow healthy tissue to grow.

Conditions:

LEEP may be performed when cervical or vaginal problems are found during a pelvic examination, or abnormal cells are found during a Pap test. LEEP is also performed to detect cancer of the cervix or vagina.

LEEP may also be used to assist in the diagnosis or treatment of the following conditions: Polyps, genital warts (an infection with human papilloma virus with a risk factor for developing cervical cancer)

Procedure: LEEP begins much like a regular pelvic exam. The patient will remain awake throughout the procedure, and may experience minor discomfort. A speculum will be inserted into the vagina and opened so that the cervix can be seen. A vinegar (acetic acid) or iodine solution, which makes abnormal cells more visible, may be applied to the cervix before the procedure is done. Your physician then places a colposcope near the opening of the vagina. The colposcope, which remains outside of the vagina, provides a magnified view of the cervix. The cervix is then numbed with local anesthesia. An electrically charged loop made of thin wire is inserted through the speculum and up to the cervix. As the loop is passed across the cervix, it cuts away a thin layer of surface tissue, removing the abnormal cells. This tissue will be later tested for cancer or abnormal cells. Finally, a medicated paste is applied to the area to prevent bleeding. It removes abnormal tissue high in the cervical canal that cannot be seen during colposcopy. In this situation, LEEP may be done instead of a cone biopsy.

Recovery: Vaginal drainage or spotting is normal for 1 to 3 weeks following the procedure. The medication paste will produce a greenish-yellow discharge immediately after the procedure. A brownish-black vaginal discharge is also normal. Pads may be used for discharge. You should avoid placing anything in the vagina for 4 weeks, including tampons. Your menstrual cycle will not be disrupted by this procedure. Avoid excessive activity for 48 hours after the procedure. Refrain from exercising for at least 1 week. You can begin exercising again in 1 to 2 weeks. Stop exercising if bleeding other than normal menstruation occurs. If excessive bleeding occurs after you resume normal activities, call your physician. Abstain from sexual intercourse for 3 to 4 weeks.

Complications: As with any surgical procedure, complications may occur. Some possible complications may include, but are not limited to, the following: Infection, bleeding, changes or scarring in the cervix from removal of tissue, difficulty getting pregnant or potential for preterm birth or having a low birth weight baby. Narrowing of the cervix (cervical stenosis) can cause infertility. There may be other risks depending upon your specific medical condition. Be sure to discuss any concerns with your physician prior to the procedure.

Certain factors or conditions may interfere with LEEP, but are not limited to the following: Menstruation acute pelvic inflammatory disease or cute inflammation of the cervix.

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Dr.B.Kalpana

M.D(O&G) FNB(Reproductive Medicine), FICOG

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