Loop Electrosurgical Excision Procedure
(LEEP, LLETZ—Large Loop Excision of the Transformation Zone, LLEC—Large Loop Excision of the Cervix, Loop Cone Biopsy of the Cervix)
Reasons for Procedure
- Abdominal cramping
- Future pregnancy problems (small increased risk of premature births and having a low birth weight baby)
- Narrowing of the cervix (rare)
- Incomplete removal of the abnormal tissue
- Accidental cutting or burning of normal tissue
- Chronic disease such as diabetes or obesity
- Menstruation at the time of the procedure—It is best to have LEEP done when you do not have your period.
- History of pelvic inflammatory disease
- Inflammation of the cervix
- Pregnancy or possible pregnancy
What to Expect
Prior to Procedure
- If your doctor will be giving you a sedative, arrange for someone to drive you home from the clinic.
- If directed by your doctor, take a pain reliever before the LEEP.
- Bring sanitary napkins to use after the procedure.
Description of the Procedure
How Long Will It Take?
How Much Will It Hurt?
- Washing their hands
- Wearing gloves or masks
- Washing your hands often and reminding visitors and healthcare providers to do the same
- Reminding your healthcare providers to wear gloves or masks
- Dark brown-black vaginal discharge for several days
- Mild cramping
- Watery pink discharge
- Rest when you get home.
- Frequently change the sanitary pad.
- Take pain medication as directed.
It will take a few weeks for your cervix to heal. For 4 weeks:
- Do not use tampons or douches.
- Refrain from sexual intercourse.
- Do not do any heavy lifting.
- It is okay for you take baths and showers.
- If advised by your doctor, have a Pap test and pelvic exam every 6 months.
Call Your Doctor
- Heavy bleeding (more than your normal period)
- Bleeding with clots
- Severe abdominal pain
- Fever or chills
- Unusual odor or discharge
American Congress of Obstetricians and Gynecologists http://www.acog.org
Family Doctor—American Academy of Family Physicians http://familydoctor.org
Canadian Women’s Health Network http://www.cwhn.ca
Society of Obstetricians and Gynaecologists of Canada http://www.sogc.org
American Congress of Obstetricians and Gynecologists. Management of abnormal cervical cytology and histology. Practice Bulletin. 2010; 99.
Emam M, Elnasar A, Shalen H, Barakat R. Evaluation of a sinfle-step diagnosis and treatment of premalignant cervical lesions by LEEP. Int J Gynaecol Obstet. 2009;107(3):224-7.
Loop electrosurgical excision procedure (LEEP). American Congress of Obstetricians and Gynecologists website. Available at: http://www.acog.org/Patients/FAQs/Loop-Electrosurgical-Excision-Procedure-LEEP. Updated July 2014. Accessed October 7, 2015.
Loop electrosurgical excision procedure (LEEP). American Society for Colposcopy and Cervical Pathology website. Available at: http://www.asccp.org/Education/COURSES-Comprehensive-Colposcopy-HRA-Advanced-and-more/Loop-Electrosurgical-Excision-Procedure-LEEP. Accessed October 7, 2015.
Noehr B, Jensen A, Kjaer SK. Depth of cervical cone removal by loop electrosurgical excision procedure and subsequent risk of preterm delivery. Obstet Gynecol. 2009;114(6):1232-8.
- Reviewer: Andrea Chisholm, MD
- Review Date: 09/2015 -
- Update Date: 01/28/2014 -