Risks of the LEEP procedure
Dear OncoLink "Ask The Experts,"
I will be undergoing the LEEP procedure later this week, and was wondering what the risks are in this procedure, and how it could affect my chances of fertility later in life. Thanks in advance for your assistance.
Christina S. Chu, MD, Assistant Professor of the Division of Gynecologic Oncology at the University of Pennsylvania Health System, responds:.
The LEEP or loop electrocautery excision procedure does have some risks. The most common side effect is bleeding which may occur in about 1-8% of patients. Physicians usually take precautions such as using a local anesthetic mixed with a medication that causes the blood vessels in the cervix to constrict, or using Monsel's solution to prevent bleeding. Another rare risk of the LEEP is infection.
In regards to fertility, one of the risks associated with the LEEP is cervical stenosis, which occurs in about 1% of procedures. Cervical stenosis occurs when scarring after the procedure causes an abnormal narrowing in the opening of the cervix. This may cause difficulty getting pregnant by blocking the entry of sperm in to the uterus, and by affecting the normal mucous secretions of the cervix as well. Another risk of the LEEP is cervical deformity and possible second trimester miscarriage. This is rare, and is usually associated only with removal of large portions of tissue at the time of the biopsy.
Despite these risks, please keep in mind that LEEP has several advantages. This is a procedure that can be done in the office with local anesthesia. Also, diagnosis and treatment can be accomplished at the same time. If you have specific questions regarding your procedure, I would urge you to discuss them with your physician beforehand.