LEEP is an acronym for a medical procedure called loop extrosurgical excision procedure. It also sometimes called large loop excision of the transformation zone (LLETZ) or loop excision. In this procedure, a small electric wired loop is used to remove tissue cells from a woman’s lower genital part (this includes both the cervix and the vagina). The electricity flowing through the wire causes it to heat up and enables it to work similar to a surgeon’s knife. The tissue cells that are cut during the procedure are intact and undamaged, which makes it a preferable choice when compared to other destructive procedures. In addition, it is also associated with a lower cost and fewer side effects.
Why Would You Need a LEEP?
Your healthcare provider may recommend a LEEP if there is any abnormality detected in your lower genital tract. Either this abnormality could be detected during a routine Pap smear or it a finding from a cervical biopsy.
In cases where there is a suspected abnormality, LEEP is used as a diagnostic tool to obtain tissue samples from the cervix or vagina. These samples are then sent for biopsy to confirm the presence of cancer. In some cases, LEEP may reveal the presence of precancerous cells (cells abnormal but not cancerous) which could be an early indicator of cancer development.
In cases where there is confirmation of abnormal tissue growth, LEEP can be used to treat the condition by removing the abnormal cells and allowing healthy cells to grow back in their place.
What Will Happen During a LEEP?
At your LEEP appointment, you will need to undress and lie on the exam table the way you would for a pelvic exam. Your healthcare provider will use speculum to open up your vagina and expose your cervix. Doctor may then use a colposcope (an instrument like a microscope) and place it at the opening of your vagina to better visualize the internal tissues. The vagina and cervix may be doused using either an iodine or a vinegar solution as these cause the abnormal cells to change color and these are then easier to identify. The doctor will then use a local anesthetic, so you do not experience pain during the procedure. The LEEP wire will be inserted through the speculum into the vagina and pierced through the abnormal tissues. The electric current from the wire will seal the cut blood vessels and stop the bleeding. The tissue specimens collected can then be sent for biopsy.
Can You Have a LEEP Procedure While You Are On Your Period?
It is possible to perform LEEP during periods, as no physical barrier prevents the tool’s wire from entering the vagina and slicing the targeted tissues. However, it is highly recommended to wait until the periods get over before performing LEEP.
One reason is that a successful LEEP depends largely on having clear visualization of the tissues within the vagina and cervix. Typically, the healthcare provider will use colposcopy to study the internal tissues. The vaginal area may be doused with vinegar or iodine so that the abnormal cells change color and become easy to identify. Now visualization will be compromised during menstruation because of the steady flow of blood from the vagina.
It is also comparatively less painful and uncomfortable for the patient if they wait until after their period gets over. This is because the vaginal area is very sensitive during periods and many women experience painful cramps and other muscle aches during these days. This is also a procedure where the patient must remain completely still as movement could lead incorrect tissue slicing.
Therefore, if you start your period before your LEEP appointment, it is advisable to let your healthcare provider know so that they can evaluate the criticality of your condition and if possible, reschedule to a date after your period gets over.