Loop Electrosurgical Excision Procedure (LEEP)
Definition - What does Loop Electrosurgical Excision Procedure (LEEP) mean?
A loop electrosurgical excision procedure (LEEP) is a procedure to remove abnormal tissue from the cervix. An electrical current is passed through a thin loop of wire that acts like a scalpel to remove the tissue.
LEEP is generally performed to treat cervical dysplasia after abnormal PAP test results. It can be done to treat abnormal cells or as a diagnostic procedure, where tissue removed is examined for abnormal cell changes. LEEP has been associated with with an increased risk to future fertility and pregnancies.
LEEP may also be referred to as a loop excision or a large loop excision of the transformation zone (LLETZ).
FertilitySmarts explains Loop Electrosurgical Excision Procedure (LEEP)
A LEEP is generally performed under local anesthetic as an outpatient in hospital or at a doctor's office. It is a quick procedure and it can be expected to resume to normal activities within 1-3 days. Side effects include mild cramps following the procedure and spotting for up to three weeks.
While most women do not experience fertility or pregnancy-related side effects from LEEP, there are risks associated with the procedure. LEEP can cause a shortening of the cervix leading to an increased risk of an incompetent cervix, where the cervix is unable to stay closed during pregnancy and can lead to early delivery. In cases of cervical incompetence, a cervix can be sewn shut through a procedure called a cervical cerclage.
Cervical stenosis can occur in around 5% of women who have had LEEP, leading to a narrowing of the cervix caused by scar tissue. In serious cases scarring can block the passageway for sperm. It is possible to remedy this issue with cervical dilation. Cervical stenosis may also cause issues with dilation during labor.
Infertility is another possible side effect from LEEP and the exact cause remains unknown. One theory is that the loss of cervical tissue leads to a reduction in cervical mucus, the fluid that provides nutrients and helps to transport sperm to an egg.
Treatment for infertility depends on the diagnosis, but intrauterine insemination is an assisted reproductive technology (ART) that can help the sperm bypass the cervix and enter directly into the uterus.