January 15, 2017 Liza Colimon, MD A LEEP procedure is indicated once moderate or severe high grade dysplasia (abnormal cells) are confirmed after colposcopic examination and biopsies. If your pathology report from your biopsies shows the following you will likely need a LEEP procedure depending on your age: Cervical Intraepithelial Neoplasia II (CIN II) Cervical Intraepithelial Neoplasia III(CIN III) The procedure is both diagnostic (helps to ensure abnormal cells diagnosed are not more worrisome than reported after colposcopic biopsies) and therapeutic (removes the abnormal cells preventing further growth). A loop connected to an electrical generator is used to remove the area on the cervix where the abnormal cells were identified. The Loop gets very hot and is only used to remove a very superficial layer of the cervical tissue/skin. The procedure takes approximately 10 minutes. You will be placed in the same position as you are during a pap smear, Often times, another colposcopy is typically performed prior to removing the cells to better identify the area of concern. The procedure is typically performed in the office but may also be performed in the operating room. You will go home the same day. If being performed in the office, only local anesthetic injected into the cervix will be used. You should abstain from placing anything in the vagina or intercourse for at least three days prior to the procedure and for up to four weeks after the procedure. If you start your period prior to the procedure, it should be rescheduled. Ideally you would schedule your LEEP procedure when you are not expecting your period for 2 weeks or so to avoid confusion as it will be difficult to know if you are bleeding due to your period or because of complications from your LEEP procedure.