Loop Electrosurgical Excision Procedure (LEEP)

Women who have a Pap smear showing abnormal cells on their cervix may find that their physician will suggest an electrosurgical procedure commonly called LEEP to remove those cells. This minimally invasive procedure uses a thin wire loop through which an electric current is passed to remove a thin layer of tissue containing the abnormal cells. The procedure is performed in a doctor’s office and seldom takes more than a few moments.

A speculum is placed. After a local anesthesia is administered, the thin wire loop is inserted into the vagina and to the cervix. Electrical current is applied to the loop and the loop acts as a scalpel to remove the abnormal tissue. The tissue is then evaluated to make or confirm a diagnosis. Other procedures can be used to remove the abnormal cells and include:

• cryosurgery
• laser treatment
• cone biopsy

However, the actual procedure used depends upon how much tissue needs to be removed and where the cells are located on the cervix. Recovery time usual takes several weeks. Like all procedures LEEP does have some risks so it is important to understand them before having the procedure.

Dilatation and Curettage (D&C)

The D&C, or Dilation and Curettage procedure, is one of the most common surgical procedures performed on women. Depending on a patient’s condition and health, a D & C may be performed in a physician’s office or in a hospital. It is used to:

• diagnose and or treat abnormal uterine bleeding including heavy or prolonged menstruation
• diagnose and or treat unexplained bleeding between periods
• provide information regarding the presence of uterine cancer and in the removal of non-cancerous growths such as polyps
• remove retained tissue after a miscarriage
• for elective pregnancy termination

The procedure involves placing an instrument called a speculum into the vagina to hold the vaginal canal open. . Anesthesia administered to the cervix minimizes discomfort.

The physician will then use gentle suction or insert a curette (a metal loop on the end of a long thin handle) and gently scrape the inner layer of tissue (endometrium) for collection and examination.

D&C has few risks including perforation of the uterus and infection. Patients may return to normal activities as soon as they feel better, often the same day.