Colposcopy & LEEP Treatment
Colposcopy and LEEP procedures: what you should know.
Colposcopy is performed to further evaluate an abnormal Pap test. The colposcope is a lighted magnifying glass that helps us see abnormal areas on the cervix. These abnormal areas are usually cells that have undergone changes due to infection with the human papillomavirus (HPV). HPV is the primary cause of cervical cancer. HPV infection is very common, and most women acquire at least one HPV infection at some point in their lifetime. Fortunately, most women spontaneously clear the infection on their own. However, if a woman has an abnormal Pap, colposcopy allows us to examine the cervix for HPV-related alterations, and to take small biopsies to look for evidence of precancerous changes of the cervix. If you are concerned about HPV, Boulder Gynecology can conduct an HPV screening test when indicated and discuss your questions with you.
We follow the most recent national guidelines published by the American Society for Colposcopy and Cervical Pathology (ASCCP)for the evaluation of abnormal Pap tests. We aim to detect precancerous changes early–and intervene where necessary–while avoiding overtreatment and needless anxiety.
Loop electrosurgical excision procedure, or LEEP, is the preferred method for eradication of precancerous cervical cells confirmed by colposcopic directed biopsies. LEEP is performed in the office with local anesthetic injected into the cervix. A small wire loop is used to shave off the precancerous cervical cells. This procedure is only used for women with “high grade” or true precancerous cervical lesions.
Most women tolerate the LEEP procedure very well; complications are uncommon and recovery is generally prompt. Furthermore, LEEP as compared with cryotherapy, an older method that freezes abnormal cells, provides a specimen that can then be evaluated by a pathologist. For these reasons, LEEP is the only method that we use to remove precancerous cells. Because “low-grade” cervical lesions merely indicate HPV infection that will generally resolve on its own, we do not perform LEEP in such circumstances. Our approach is to follow such patients closely with repeat Pap testing, HPV screening and/or colposcopy.
Psychological impact of colposcopy and LEEP
Although colposcopy and LEEP are fairly simple procedures, women can often underestimate the psychological impact of having them performed. Colposcopy or LEEP can be emotionally difficult because the woman is in a vulnerable position (in the stirrups) while a procedure is being performed for evaluation of a potentially life threatening disease (cervical cancer). If you are in need of colposcopy or LEEP, please be gentle with yourself and give yourself permission and time to work through the emotions. We welcome you to bring a support person to be with you during the procedure. If you have someone to help transport you to and from our Boulder office, we can also prescribe a mild anti-anxiety medication to help with the procedure. Please talk to us about what would make you feel most comfortable when you schedule the appointment.
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