How is the Electrosurgical Excision Procedure (LEEP) performed?

The LEEP lasts a few minutes. The patient is in gynaecologic position and the doctor places the vaginal dilator to find the cervix. Before the surgery, it is useful to perform vaginoscopy, in order to re-identify the damage and define the size and shape of the loop needed. Local anaesthesia or mild sedation is able to control pain. Then the doctor places the loop around and under the transition zone, which is the area of the cervix where most HPV lesions appear. In the case there is residual damage or there are lesions higher in the cervix, the doctor will need to repeat the process before the surgery is completed. Finally, in order to fully examine the cervix, cervix curettage is sometimes necessary. Haemostasis is achieved with cauterization and use of special solutions. It is pointed out that conisation with loop should be avoided during menstruation.

What are the complications of Conical Cervical Resection?

The complications of Conical Cervical Resection are rare and mainly involve infection and increased blood loss during the surgery or during the first weeks postoperatively. In the long term, Conical Cervical Resection is likely to affect future pregnancies of the patient because it slightly increases the risk of spontaneous abortion, preterm labour and delivery of a low-weight newborn. These obstetric complications are likely to occur in women in whom conisation was performed in greater depth or needed to undergo the same surgery more times. Postoperative stenosis of the cervical opening, which can block blood flow during menstruation, is rare. 

What is expected when recovering from Conical Cervical Resection?

The patient can postoperatively develop minor vaginal bleeding, mild cramping on the lower abdomen and brown or black vaginal discharge due to the substances used for haemostasis. Recovery of the cervix takes time. In this context, the patient should avoid vaginal washes, sexual activity, tampons and vaginal creams and staying in the water for a few weeks. The doctor will determine when it is safe for the patient to return to her normal activities. In case of heavy or long-lasting vaginal bleeding, fever, foul-smelling discharge and intense abdominal pain, the patient should contact the doctor immediately.