LEEP: Removing Abnormal Cervical Tissue Before It Becomes Cancer
LEEP — loop electrosurgical excision procedure — uses a thin wire loop carrying electrical current to excise the transformation zone of the cervix: the area where abnormal cells most commonly develop and where high-grade dysplasia (CIN 2 and CIN 3) is found. It is the most commonly performed treatment for high-grade cervical dysplasia in the United States and the standard of care after colposcopic confirmation of CIN 2 or CIN 3.
LEEP removes the abnormal tissue and sends it to pathology for histologic evaluation — confirming the diagnosis, assessing the margins of the excised specimen, and ruling out invasive disease. A clear margin on the LEEP specimen is an important prognostic indicator for the likelihood of complete treatment.
Dr. Andrei performs LEEP at Lapeer County Surgery Center as an outpatient procedure under general anesthesia. The procedure takes 10–15 minutes. Patients go home the same day and recovery is typically three to five days before returning to normal activity, with a four-week restriction on intercourse and tampon use.
Indications for the LEEP Procedure
LEEP is recommended after a specific diagnostic pathway: abnormal Pap smear or positive HPV test, followed by colposcopy, followed by biopsy confirmation of high-grade dysplasia.
CIN 2 (moderate dysplasia)
Colposcopic biopsy confirming moderate cervical dysplasia — the threshold at which treatment is recommended for most women rather than continued surveillance.
CIN 3 (severe dysplasia or carcinoma in situ)
High-grade dysplasia involving the full thickness of the cervical epithelium — the most important precancerous lesion to treat before progression to invasive cervical cancer.
Unsatisfactory colposcopy with high-grade cytology
When the transformation zone cannot be fully visualized at colposcopy but cytology shows high-grade abnormality — LEEP is both diagnostic and therapeutic.
Persistent CIN 2 not resolving with surveillance
CIN 2 that has not regressed after an appropriate surveillance interval — particularly in women over 25 where spontaneous regression is less likely.
Prior LEEP with positive margins
When a prior LEEP specimen showed involved margins, repeat excision may be recommended to confirm complete removal of dysplastic tissue.
Adenocarcinoma in situ (AIS) after colposcopy
AIS identified on colposcopic biopsy — a glandular precancerous lesion for which cold knife conization (rather than LEEP) is often preferred for superior margin assessment.
What Happens During and After LEEP
LEEP is a short, focused procedure performed under general anesthesia at Lapeer County Surgery Center. The entire operative time is typically under 20 minutes including preparation.
The LEEP procedure is systematic and focused.
- General anesthesia administered at LCSC
- Colposcope used to visualize the cervix
- Local anesthetic with vasopressin injected into the cervix
- Wire loop passed through the transformation zone in one or two passes
- Specimen immediately placed in formalin and sent to pathology
- Cauterization of the excision bed for hemostasis
- Monsel paste applied — discharge the same day
Recovery is measured in days. The four-week restriction on intercourse and tampon use is the most important post-procedure instruction.
- Watery or bloody vaginal discharge expected for 2–4 weeks
- Mild cramping for 1–3 days managed with ibuprofen
- Return to desk work within 3–5 days for most patients
- No intercourse, tampons, or swimming for 4 weeks
- Pathology results reviewed at 2-week follow-up
- Surveillance Pap and HPV testing at 6 and 12 months post-LEEP
“LEEP is one of the most important preventive procedures in gynecology — it treats a lesion that, left untreated, can progress to invasive cervical cancer. The procedure itself is short and recovery is quick. The impact is significant.”
Before and After LEEP
LEEP at Lapeer Women’s Health is a straightforward outpatient process.
Consultation and Colposcopy Review
Dr. Andrei reviews your colposcopy and biopsy results, confirms the indication for LEEP, and explains the procedure, what to expect on the day of surgery, and the post-procedure restrictions.
Procedure Day at LCSC
You arrive at Lapeer County Surgery Center fasting. General anesthesia is administered. Dr. Andrei performs the LEEP in 10–15 minutes. You recover for a short period and go home the same day.
Pathology Review
The excised specimen is reviewed by pathology. Results are available in one to two weeks and reviewed with you at your follow-up appointment. Margin status and final diagnosis are discussed.
Surveillance
LEEP does not eliminate the need for continued cervical cancer surveillance. Dr. Andrei schedules co-testing (Pap + HPV) at six months and twelve months post-LEEP to confirm treatment response.
Recovery After LEEP
LEEP has one of the shortest recovery timelines of any gynecologic procedure.
Most patients go home within an hour of the procedure. Mild cramping is expected and managed with ibuprofen. Light spotting or watery discharge begins.
Most women return to desk work within three to five days. Watery or bloody discharge continues for two to four weeks — this is normal.
No intercourse, tampons, or swimming for four weeks to allow the cervix to heal. After four weeks, full activity resumes without restriction.
Questions About LEEP
Abnormal Pap. Clear Answer.
Treatment the Same Day.
If you have been told you need LEEP after colposcopy, schedule a consultation with Dr. Andrei at Lapeer Women’s Health. She reviews your biopsy results, confirms the indication, and performs the procedure at LCSC.
The information on this page is intended for educational purposes only and does not constitute medical advice. Individual symptoms, diagnoses, and treatment options vary significantly. Reading this content does not establish a physician-patient relationship with Dr. Ramona D. Andrei or Lapeer Women’s Health. If you are experiencing a medical emergency, call 911 or go to the nearest emergency room immediately. Please consult a qualified healthcare provider for advice specific to your situation. Content reviewed by Dr. Ramona D. Andrei, MD PhD FACOG.