Can You Have Abnormal Cells After a LEEP Procedure?

We understand it can be alarming.

Whenever abnormal cells are found during a Pap test, you may be anxious—after all, a Pap smear is one of the most effective methods of detecting cervical cancer at its earliest, and most treatable stage.

When you get the results, there are likely two burning questions in your mind: Do I have cancer? What happens next?

First, we want you to know that we are with you. As your health care team, we will support you through every aspect of this process. We want to safeguard your health, and a big part of that is being a partner in your healthcare. You can always come to us with questions and concerns. 

If you have abnormal cells, our next steps depend on a lot of factors. These include your age, the results of your previous Pap smears and the degree of change seen on your current Pap.

If a moderate to high degree of change is seen when reviewing your cervical cells, then we may conduct a LEEP procedure, which removes the cells and enables us to examine them more closely to detect any potential signs of cancer.

You may have questions about how effective a LEEP procedure is and whether or not abnormal cells will return after the procedure. We’ll address these questions, and we encourage you to contact us if you need any answers not found here.

We’ll also review other elements of a LEEP procedure, including how it’s done and how to prepare.

What Is a LEEP Procedure?

LEEP stands for Loop Electrosurgical Excision Procedure. It’s a procedure that removes abnormal or pre-cancerous cells from the surface of the cervix. These cells will be examined for cancer or, if it’s determined that cancer is already present, a LEEP may be used to remove the cancerous tissues. This procedure may also be called a conization, as a cone-shaped piece of cervical tissue is removed for examination.

A LEEP is not only used to remove possible precancerous cells from your cervix, but it’s also used to diagnose or treat:

• Polyps, which are benign growths
• Genital warts
• Diethylstilbestrol (DES) exposure. DES is a type of synthetic estrogen. Those whose mothers took DES during pregnancy are at a higher risk of reproductive system cancer. The use of DES was discontinued in the 1970s.

We’ll discuss whether or not a LEEP procedure is the best choice to aid your treatment for the appearance of abnormal cervical cells, polyps or genital warts.

During a LEEP, a tiny, wire loop with an electrical current that acts like a small, accurate scalpel is used to remove any abnormal cells and tissue. Its precision enables us to reach the targeted area while leaving healthy tissue alone. It’s typically performed under local anesthesia in the form of numbing medicine injected into your cervix, so you’ll have minimum discomfort.

Any woman who has had a significantly abnormal Pap smear or has had evidence of precancerous cells may be considered for a LEEP. 

How Effective Is the LEEP Procedure?

A LEEP has an excellent 90% success rate in preventing cervical cancer. Of course, these figures vary depending on how advanced your cervical abnormalities are and how many cells need to be removed for your procedure.

Can You Have Abnormal Cells After a LEEP Procedure?

A LEEP procedure is exceptionally effective at removing any abnormal or precancerous cells from your cervix. However, depending upon your individual situation, abnormal cells may return again, which is why we want to have follow-up appointments and regular cervical cancer screenings with you. How often will depend upon many factors, including your individual case and your family history.

In general, women who have had LEEP procedures need to have a follow-up Pap in 1 year. There are situations when a 6-month follow-up and a 1-year follow-up Pap smear are required.

What Happens During a LEEP Procedure?

We mentioned this a bit earlier, but we’ll go into greater detail below.

During this treatment, we first apply a solution to your cervix that makes the abnormal cells easily visible. We use a specialized scope to obtain a magnified view of your cervix. 

Then your cervix is numbed using a local anesthesia before an electrically-charged thin wire loop is passed across the cervix, removing surface tissue and abnormal cells. After the procedure, we apply a medicated paste to prevent bleeding.

The procedure itself usually takes around 10 to 20 minutes, and you can go home after the procedure has been completed. Because only local anesthesia is used, you will be able to drive.

How Do I Prepare for a LEEP Procedure?

Our leading healthcare team of gynecologists in Chapel Hill and Durham is dedicated to providing treatment plans tailored to each individual. Therefore, depending on your situation, we will provide specific instructions to best serve you. Typically, a LEEP should not be performed when you are on your period. 

As a general guideline, you should do the following in preparation for a LEEP procedure:

• Usually, there is no need for fasting or sedation because only local anesthesia is used.
• Let us know if you are pregnant or think you may be pregnant.
• Be sure to let us know if you have changed medications or added new medications to your routine. This includes any herbal remedies or supplements. 
• It’s particularly important to let us know if you have a history of bleeding disorders or are taking medicines such as aspirin that can thin your blood.
• Do not use tampons before your procedure.
• Do not douche or use vaginal creams before the procedure.

We will also review your medical history with you, making sure that you are not allergic to latex, tape, or the anesthetic that will be used. 

We want you to know that we understand you may be a bit nervous or anxious, and we want to reassure you that we are here for you and we’ll take time to answer any questions you have.

What Should I Do After a LEEP Procedure?

You will be able to go home after the LEEP procedure, although you may want to rest for a few minutes before leaving our office. Don’t worry if you have spotting or dark discharge for a few days—this is normal, and you may want to wear pads until the discharge stops.

Don’t douche, use tampons or have sex for 2 – 4 weeks after the procedure. It’s also a good idea to avoid heavy lifting or strenuous tasks the day of the procedure, and you may want to take an over-the-counter pain reliever for cramping that sometimes occurs after a LEEP.

Let us know as soon as possible if you experience any of the following symptoms:

• Fever
• Chills
• Abdominal pain
• Bleeding that contains clots
• Foul-smelling drainage from your vagina

We’ll provide a more detailed set of instructions after your LEEP procedure.

What Do the Results of My LEEP Procedure Mean?

Ideally, the results indicate that there is no cancer, and sometimes the LEEP procedure is able to remove all pre-malignant and malignant cells (if present). If malignant cells are present, you will be referred to a gynecologic oncologist for further evaluation and recommendations.

What Is My Risk of Developing Cervical Cancer?

Thankfully, the Pap smear test has greatly reduced the number of deaths from cervical cancer because it detects it at the earliest stages. 

Still, every year, there are around 13,360 new cases of invasive cervical cancer, and 4,320 women will die from cervical cancer, according to information from the American Cancer Society.

We want to stand by your side in the fight against cervical cancer, and that starts with education and regular screenings. You are at greater risk of developing cervical cancer if:

• You’ve been infected with HPV
• You’ve had many sexual partners, or you have a sexual partner who is in a high-risk category
• You smoke
• You have a compromised immune system
• You’ve had three or more full-term pregnancies
• You had your first full-term pregnancy before you were 20
• You have a diet low in fruits and vegetables
• You have a family history of cervical cancer
• Your mother took Diethylstilbestrol (DES) during pregnancy

We’re By Your Side in the Fight Against Cervical Cancer

Let’s be clear—having abnormal cervical cells does not necessarily mean that you have cervical cancer. However, it does mean that those cells need to be closely examined. 

Depending upon the degree of change and your Pap smear history, a LEEP may be the best approach to your care.

We know this can cause a lot of anxiety and worry, and that’s why we want you to know that we will be by your side through every step, encouraging you and providing the vital information you need to make educated decisions about your health care.

If you’re past due for your Pap smear, we encourage you to schedule an appointment with us today and see why generations of Triangle area women have trusted us for more than 40 years.

We’ve been providing care for more than four decades

When it comes to your health, you need both advanced technology and compassionate care to ensure a healthy life. We provide our patients the personal experience expected from a small, private practice with the advanced resources found at larger research universities. 

If you have any questions or concerns or would like to know more about your potential risk for cervical cancer, please contact us to schedule an appointment.

We would love to have the opportunity to serve you.