LEEP Procedure

LEEP Procedure in Turkey: Treating Cervical Pre-Cancer Without Major Surgery

What is the LEEP procedure? Learn how CIN 2 and CIN 3 lesions are treated, the recovery process, and fertility preservation. Expert LEEP treatment in Istanbul with Dr. Cengiz Andan.

A Small Procedure to Prevent a Big Problem

Receiving a “high-grade abnormality” (CIN 2 or CIN 3) result from a Pap smear or biopsy can be frightening. It naturally raises the fear of cancer. However, the good news is that these cells are not yet cancer—they are warning signs. By removing these abnormal cells with a simple procedure called LEEP (Loop Electrosurgical Excision Procedure), the risk of developing cervical cancer can be eliminated.

Often referred to as “cervical shaving,” LEEP serves a dual purpose: it confirms the diagnosis and treats the condition simultaneously. At Dr. Cengiz Andan’s Clinic in Istanbul, we prioritize organ-preserving approaches. We treat the diseased area precisely without the need for a hysterectomy, protecting your uterus and future fertility.

1. What is LEEP? Why is it Performed?

LEEP uses a thin wire loop that carries a gentle electrical current. This loop acts like a fine scalpel to shave off the abnormal layer of tissue from the cervix (the opening of the womb).

When is it Recommended?

• CIN 2 & CIN 3: When a biopsy confirms moderate to severe dysplasia (abnormal cell growth). Removing these cells prevents them from progressing to cancer.
• Persistent CIN 1: For low-grade changes that do not resolve on their own over time.
• Diagnostic Clarity: When there is a discrepancy between the Pap smear result and the biopsy, LEEP provides a larger tissue sample for a definitive diagnosis.

2. The Procedure: Step-by-Step

LEEP is typically an outpatient procedure, meaning you go home the same day. It is quick and generally well-tolerated.

1. Preparation: You lie on a gynecological exam chair. To ensure you feel no pain, we administer a local anesthetic (numbing injection) into the cervix or use light sedation (twilight sleep) for maximum comfort.
2. Excision: The doctor uses the heated wire loop to precisely remove the abnormal tissue and a small portion of the cervical canal. The heat from the loop also seals blood vessels, minimizing bleeding.
3. Pathology: The removed tissue is sent to a lab intact. This allows the pathologist to confirm if the edges are clear of abnormal cells (“clean margins”) and ensure no cancer is present.
4. Duration: The actual procedure takes only 10 to 20 minutes.

3. Recovery and What to Expect

After the procedure, you will rest for a short time and then return home. Recovery is usually straightforward.

• Pain: You may experience mild cramping, similar to period pain, on the day of the procedure. Standard painkillers are usually sufficient.
• Discharge: Expect a watery, pinkish discharge for the first week. Around 10-15 days later, you might notice some light bleeding or “spotting” as the scab on the cervix heals and sheds. This is normal.
• Restrictions: To prevent infection and allow the cervix to heal, you must avoid sexual intercourse, tampons, swimming pools, and douching for 3 to 4 weeks.

4. LEEP and Future Fertility

The most common question we receive is, “Can I still have a baby?”

• Does not cause infertility: LEEP does not damage your ovaries or uterus. It does not prevent you from getting pregnant.
• Pregnancy Risks: Because a small amount of the cervix is removed, there is a very slight increase in the risk of “cervical incompetence” or preterm birth in future pregnancies. However, this is manageable. Your obstetrician will monitor your cervical length during pregnancy to ensure a safe delivery.

5. LEEP vs. Conization: What’s the Difference?

Both procedures remove tissue from the cervix, but they differ in technique and depth.

• LEEP: Uses an electrical wire loop. It removes less tissue and causes less bleeding. It is ideal for surface lesions and is often done in an office or clinic setting.
• Cold Knife Conization: Uses a surgical scalpel. It removes a deeper, cone-shaped wedge of tissue. It is preferred if the abnormal cells are suspected to be high up in the cervical canal or if there is a stronger suspicion of cancer.

Frequently Asked Questions (FAQ)

1. Is the procedure painful?No. Because we numb the cervix with local anesthesia, you should not feel pain during the procedure. You might feel a slight warming sensation or mild pressure.
2. What if the results show “clean margins”?This is the best outcome! It means the abnormal tissue was completely removed, and the healthy tissue around it is clear. The treatment is successful, and you will return to routine follow-up screenings (Pap smears) in 6-12 months.
3. Will it affect my period?No. LEEP is performed only on the cervix and does not affect your hormones or menstrual cycle. Your periods will continue as normal.
4. Can the abnormality come back?LEEP has a success rate of 90-95%. However, since the underlying cause is HPV, there is a small risk of recurrence if the virus remains active. Strengthening your immune system and quitting smoking are the best ways to prevent the lesion from returning.
5. When can I shower?You can take a shower the same day. We recommend avoiding baths (sitting in water) for 3 weeks to reduce the risk of infection while the cervix heals.

Dr. Cengiz Andan uses advanced technology and precise surgical techniques to eliminate cervical cancer risks, ensuring your health and fertility are protected.