Hello,

In May 2008, I had my first abnormal Pap. My doctor has been doing the 'watchful waiting' technique, advising regular Paps. I live in Europe, and my fourth Pap since May 2008 has resulted in a 3D level (not sure if that's the same medical terminology in the United States)?

My American friends said that the moment they were determined to have an abnormal Pap, the doctor performed a LEEP procedure. They were surprised that I have not yet had one. My doctor said she's waiting for a third at this level, and that if the situation hasn't improved then, then a LEEP will be recommended.

My Paps have twice been at the 3D level (which is a bit more progressed that my very first irregular Pap). The doctor is hoping it'll become less serious with the next Pap.

1. What complications or success stories do you have relative to the LEEP?

2. I am in my early thirties and have not yet had children. Do you think this procedure will pose a great risk for future pregnancies?

Please share your insight about the LEEP procedure!

Thank you.

Hello and thanks for posting.

A bit of background on LEEP: The Loop electrosurgical excision procedure (LEEP) involves using a thin wire loop through which an electrical current is briefly passed, making it a very precise cutting tool. The procedure is very common and is generally deemed effective: a prime advantage of LEEP is that if gives the clinician the ability to see the lesions(s) being removed and it yields a tissue sample which may be evaluated further.

The cervix is numbed prior to the procedure, and medicine is applied topically to minimize bleeding. Discomfort is usually described as little if any, although some do report feeling a mild pressure or cramping sensation.

Complication rates post-LEEP are usually very low according to most studies. It's not unusual for there to be bleeding or discharge afterwards; we encourage you to ask your health care provider what you may expect and what sorts of things they may want you to inform them about.

Follow-up exams are typically scheduled 4 months after LEEP, and it's usually recommend not to do any heavy lifting or insert anything vaginally for several weeks afterwards (again, consult with your clinician as to specific recommendations for your case).

The choice of treatment when cervical lesions are removed depends on numerous factors: size, location, and distribution of lesions; age and pregnancy status; health care provider and patient preference. Some providers are simply more aggressive than others and, of course, a woman's medical history can also dictate different approaches to her management in this regard. In other words, no one size fits all approach!

The general line with fertility is that most women are able to have normal pregnancies following LEEP, but discuss this carefully with your provider. There is some research that indicates LEEP is associated with an increased chance of premature delivery, and I think the issues here are especially complicated if multiple procedures are needed.

I hope this helps. Please let us know if you have other questions.

Best,
Fredo

_________________
ASHA Moderator

i just had the leep procedure yesterday, and it wasnt that bad, mostly felt pressure,not pain, no bleeding and no discharge, a bit of cramping this morning and thats it... no swimming for a month or heavy lifting, but otherwise i feel fine

I had a LEEP procedure in December 2007. It was the best thing I could have done. I had been diagnosed 3 years earlier and my ob took a wait and see approach. Before the LEEP, after being diagnosed with high risk HPV, I had one normal pap and all the rest abnormal. My dr. decided to go ahead with the leep because they had gone to the columnar area. Since that time, all my paps have come back normal.