Conization and LEEP Treatments

Conization and LEEP treatments at a glance

• Conization (cone biopsy) and LEEP (loop electrosurgical excision procedure) are treatments that identify and remove abnormal tissue from the cervix in cases of cervical dysplasia.
• Conization is also called a cone biopsy because it removes a cone-shaped section of abnormal tissue for laboratory examination.
  LEEP uses a thin electrified wire to cut out abnormal tissue high in the cervix.
• Both conization and LEEP remove abnormal tissue and provide biopsy samples suitable to determine if cancer or dysplasia cells are present.
• Conization is an inpatient procedure done in a hospital or surgery center (with no overnight stay) and LEEP is an outpatient procedure done in a clinic.
• Some risks from the procedures include abnormal vaginal bleeding, an increased chance of preterm deliveries, and the rare possibility of the narrowing of the cervix that can result in infertility.

What are conization and LEEP?

Conization (cone biopsy or cold knife biopsy) and loop electrosurgical excision procedure (LEEP) are treatment options for women with cervical dysplasia that remove abnormal and precancerous tissue and provide a biopsy sample.

Conization removes a cone-shape section of precancerous tissue high in the cervix to provide a biopsy sample for laboratory examination to tell if cancer is present.

LEEP uses a low-voltage electrified wire to remove abnormal tissue that has been identified in a colposcopy, which provides a magnified view of the cervix. LEEP can also remove abnormal tissue higher in the cervix not visible with colposcopy. LEEP is preferred in these instances over conization.

Cervical dysplasia is a condition in which precancerous cells build up on the cervix surface. Although typically not cancerous, if cervical dysplasia goes untreated, it may lead to cervical cancer. Cervical dysplasia is typically discovered during a Pap smear.

The stage of the dysplasia along with recommendation from a gynecologic oncologist will guide which procedure path a woman chooses. Conization procedures are more precise and can remove more tissue than the LEEP method. LEEP is more frequently used in high-grade cervical dysplasia cases and is both a treatment and diagnostic procedure.

How are conization and LEEP performed?

Conization is a surgery that removes the abnormal, precancerous cells from the cervix. Conization is essentially an intensified biopsy of the cervix that removes a large cone-shape section of the abnormal tissue, as well as a small amount of normal tissue so an area of normal tissue remains in the cervix.

Conization may be performed in conjunction with LEEP. Conization removes the cone-shape tissue for biopsy and LEEP is used to remove abnormal tissue.

Typically performed under general anesthesia, conization gives patients an option for a local anesthetic that numbs the entire genital area or an epidural. The surgeon removes a large portion of the cervix. Once removed, the tissue is sent to a pathology lab.

The LEEP method uses a wire loop device powered by low-voltage electricity that is inserted vaginally to remove abnormal cells from the cervix. LEEP removes fewer cells, and is generally less expensive and easier to perform than the conization. Patients do not go under general anesthesia during LEEP; the gynecologist oncologist numbs the cervix with local anesthesia.

Also known as electrosurgery, a LEEP procedure removes tissue that is then tested for cancer. This helps diagnosis, as well as helps to guide a course of future treatment for the abnormality. Following either a LEEP or conization procedure, the tissue is sent to a pathology lab for testing to confirm a diagnosis and continue with a proper treatment plan.

Recovering from conization and LEEP

Following a conization or LEEP procedure, patients are monitored for a few hours before going home. Vaginal bleeding may occur in the week following either procedure. Women should wear pads instead of tampons if menstruating for three weeks following the procedure, as well as avoid all sexual penetration.

Following a conization procedure, women will need to get a Pap test every six months, or as often as recommended by a gynecologic oncologist, until several test results come back normal.

Risks & side effects of conizaton and LEEP

Conization does carry some surgical risks.

• Sometimes the bleeding following the surgery is so severe that follow-up treatments are required.
• In rare cases, conization causes the cervix to narrow, creating fertility issues.
• Women who have undergone conization also have an increased chance of miscarrying or having a preterm delivery.
• Conization may cause scarring that may make future exams difficult in identifying abnormal tissues and cells.

LEEP has proven to be a very effective treatment for cervical dysplasia. Some risks to consider include the rare chance of infection of the cervix, narrowing of the cervix (with possible fertility issues) and preterm delivery.

University care is driven by its patients, not profits.

The Division of Gynecologic Oncology at CU Anschutz provides comprehensive treatments and services for all patients.

Because the University of Colorado Anschutz is a research-backed institution, our doctors can take on even the most complex cases, and patients receive the best and most modern care available.

Patients may also participate in the many available cancer research and clinical trials.