- abnormal histopathological results
- abnormal cytology results
- abnormal cervical colposcopy results
- diagnosis of cervical erosion or leucoplakia
- diagnosis of mild, moderate or severe cervical dysplasia
Cervical electroconization (LEEP – loop electrosurgical excision procedure) is a therapeutic and diagnostic method for women with abnormal cytology or colposcopy results. An electrosurgical loop, carrying low voltage current, is used to collect material necessary to make further diagnosis, i.e. histopathological examination. If the cervix is covered with abnormal tissue it is possible to remove it through the procedure. The surgery serves then a therapeutic function.
Cervical electroconization has a few advantages which make it popular. First of all, patients tolerate electroconization procedure better than surgical conization used previously. Moreover, the procedure is simple to perform and relatively inexpensive. Cervical electroconization may be carried out in the outpatient facility, whereas the surgical conization requires an operating room which entails higher costs.
Preparation for the procedure
The procedure may be performed in women who have not been diagnosed with inflammation in vagina or urinary tract. LEEP is carried out in the first cycle phase, immediately after menstruation.
The patient should inform the doctor about the drugs taken; if the derivatives of acetylsalicylic acid are taken, the product should be discontinued, after the consultation with the doctor approximately 2 weeks before the procedure.
Before the surgery the patient should be in a fasting state. It is recommended to eat the last meal around 6.00 p.m. on the day preceding the procedure. An analgesic may be taken immediately before the examination in order to alleviate unpleasant sensations resulting from the procedure.
Is the procedure painful?
LEEP procedure is routinely performed in an outpatient facility under local anaesthesia. In such case the patient may experience discomfort related to minor pains. They occur when the cervix is infiltrated with 1-2% lidocaine solution.
The cervical electroconization may also be performed in an operating room under general anaesthesia. In that case the patient does not experience any ailments during the procedure.
The course of the procedure
The patient is laid down on the chair in a so-called gynaecological position. Then, by means of a speculum, the cervix is accessed. General anaesthesia, if chosen, is given before the specula are applied. When the patient is anaesthetised an electrical loop is inserted which is used to excise a fragment of cervix in a form of a cone of 1.5 cm in height. It constitutes material for histopathological examination. If abnormal tissue is detected within the cervix, if possible, it is removed by the electrical loop. A low voltage current is transferred through a thin wire inserted to the vagina.
The procedure lasts up to 40 minutes.
The cervical electroconization may be followed by the curettage of the uterine cavity. The entire material collected during the procedure undergoes histopathological examination.
- if pains occur it is recommended to take analgesic to alleviate unpleasant sensations;
- it is recommended to limit sexual intercourses until the next menstruation is finished;
- tampons should not be used during menstruation, vaginal irrigation should not be performed;
- after 10-14 days there may occur bleeding resulting from the peeling of the slough which was created in the cervix by the use of the electrical loop;
- a follow-up visit is recommended after about 3 weeks after the procedure, unless the doctor sets a different date;
Contraindications and side effects
The method is considered safe. The following complications may occur on rare occasions:
- there is a risk of haemorrhage during the procedure;
- spotting or leucorrhoea may occur after the procedure;
- an infection of lower reproductive tract may develop as a result of the procedure
- scars resulting from the procedure may hinder the process of impregnation;
- sometimes the opening of the cervix may get narrowed.