Deep down, you know how it is:
The anxiety and emotional stress leading up to LEEP is so intense, that you wish it is over by now and things are all back to normal.
Reality is, you are keen on what to expect after a LEEP –
including the LEEP procedure recovery time, the aftercare and exercise when recovering from this cervical surgery, and the post LEEP restrictions on your road to full recovery.
This guide will walk you through the whole process, including clinical review of LEEP procedure side effects, risks, and potential complications that you should know.
Let’s jump right in.
On The Day: During and After LEEP / LLETZ Procedure
Loop Electrosurgical Excision Procedure (LEEP), or Large Loop Excision of the Transformation Zone (LLETZ), is a procedure that uses low voltage electric current to remove abnormal tissue from the cervix. LEEP is usually conducted as an outpatient procedure which does not take long, normally it takes around 5 to 10 minutes.
Patients that are put to sleep under general anesthesia would not feel anything during the LEEP operation. According to eMedicineHealth, the doctor / OBGYN will apply special chemical substance around the area of operation in order to prevent bleeding that may be taking place around it.
When local anesthesia is used, the actual LEEP procedure is normally not bad at all. However, everyone’s experiences can vary depending on how the body reacts, with some patients may have discomfort or pain that varies from mild to severe level – depends on the individual’s tolerance, while some patients described their LEEP operation experience was “traumatizing”.
Recommended read: Alternative CIN / LSIL / HSIL Cervical Treatment Options Besides LEEP
After the LEEP is done, it is best to have someone picking you up and support you when you get home. The doctor will explain what may happen post LEEP and what are the effects the medication may have on you for a few days, so that it does not get you by surprise during your LEEP procedure recovery.
Catherine King, Clinical Nurse Specialist Colposcopy, discusses LEEP / LLETZ in video below – including what happens during the treatment, and what might happen after a LEEP procedure.
What To Expect After a LEEP Procedure: Any Side Effects?
There are instructions that will be given by the doctor before you leave the hospital, so that you can have better and smoother recovery from the procedure.
While women had fairly wide ranging experiences, here are what you may expect after a LEEP procedure, and it helps when you are aware of them in order to avoid raising unnecessary panic.
These are normal things that you may experience and they should go away after a few day, however, some may take several weeks before they disappear:
1. Abnormal Discharge
You may have dark or brownish discharge that is due to the medication that the doctor applied on the cervix area that was operated on to control bleeding. This is normal an should not raise any alarm.
You may also experience watery discharge that looks pink in color. This can happen for several weeks. Sometimes it may be heavy and with some blood spots in it. The discharge may have some foul smell.
2. Vaginal Bleeding
According to the Memorial Sloan Kettering Cancer Center, vaginal bleeding is another symptom that patients may experience when recovering from LEEP procedure:
You may have vaginal bleeding that looks like menstrual flow for 1 to 4 days after your procedure. You may notice more vaginal bleeding 10 to 12 days later as you’re healing. The amount of discharge and bleeding varies for every woman. You may have late or heavy period after the procedure, it’s normal.
3. Cramping and Pain
You may also experience mild cramping and pain for a day immediately after the procedure. The cramp and pain (eg. cervix / pelvic / abdominal / lower-back / rectal pain etc) may last longer for some patients and may cause some discomfort for several weeks, with pain decreased by the day.
More often than not, patients look turn to over the counter medication to handle the pain. It is always advisable to consult your doctor about the OTC drugs before you start using them.
4. Bloating and Constipation
It is common for patients to experience bloating for approximately 2 to 4 weeks after LEEP procedure and Dilation & Curettage (D&C), according to Island Oncology and various patients’ complaint. When patients felt bloated with gas, they may also encounter constipation and swollen tummy.
Other post LEEP problems that don’t seem normal include fatigue, constant discharge, late or heavy period, and sore throat (from anesthesia).
In video below, patient Amanda Velasquez shared the experience of her recovery from LEEP procedure.
What Is the LEEP Procedure Recovery Time: How Long Does It Take?
The normal LEEP procedure recovery time is 4 to 6 weeks, with the cervix usually takes about this long to heal. Your healthcare provider will tell you when to return for further examination, with a post LEEP follow up appointment is likely scheduled 4 weeks after your procedure to have the LEEP site examined for healing.
Sometimes, an additional 1 to 2 weeks is required for a more complete recovery.
Majority of the patients do well through the healing process, and they get fully recovered both physically and emotionally. Within this time, the patient should not experience significant pain, however most women will still experience occasional mild pain that can cause discomfort, with such condition should not last long especially when is approaching the full recovery time.
Recommended read: Natural HPV Remedies As Complementary Cervical Dysplasia Treatment
However, not all patients can have smooth post LEEP procedure recovery, with the post LEEP recovery time for some patients can be prolonged for months. These patients have to go through a lot, leave them wondering whether or not others who have undergone LEEP/LLETZ procedure have had gone through the same recovery time and abnormal experience.
In addition to abnormal discharge with dark brownish color, cramping and vaginal bleeding –
Heavy bleeding is the most common risk that happens in the first three weeks after a LEEP procedure, says the American College of Obstetricians and Gynecologists.
Others may have a complicated recovery which is characterized with various unexpected problems like bleeding with clots and a lot of pain in the abdomen should call for immediate check up by your doctor. You need to get the issue checked out and addressed immediately in order to identify the underlying problems before they potentially become bigger and serious problems.
There are those complications such as urinary infections that can cause persistent pain and even lead to other problems if they are left unaddressed. Most of the times, patients tend to suffer from various complications for quite some before going to have them checked out thinking that they will disappear just by themselves.
More often than not, some of these complications do not call for any alarm. However, it is wise to go see your doctor in order to have yourself checked out, especially when you experience persistent pain that does not get better after taking the prescribed medication. It is advisable that you get yourself checked in case you experience anything that you think is not going right.
Additionally, University of Athens conducted a clinical study on 112 women regarding healing of cervical scar tissue and regeneration of cervix at 6 months after LLETZ/LEEP for CIN, with the conclusion below is drawn:
“Cervical regeneration at 6 months after excision is dependent on the percentage of initial cervical volume excised and on the remaining cervical tissue immediately after conisation. The greater the cone and the less cervical tissue remaining, the less the degree of cervical regeneration achieved.”
LEEP Procedure Aftercare: What To Do When Recovering?
Cervix is a highly sensitive and vital body part of a woman, therefore LEEP procedure aftercare is very important to ensure full recovery while maintain healthy cervix.
When you make the decision to have LEEP procedure done, you need to prepare for aftercare that may last for about 4 to 6 weeks which is often the recovery time after the procedure:
- Wear sanitary pad for at least one to two days after your LEEP procedure, in case you have some vaginal bleeding. Change the sanitary pad when it gets dirty or wet.
- Take Acetaminophen (like Tylenol) and Ibuprofen (eg. 800mg Motrin or Advil) that can help with cramping, or other medications and pain relievers as prescribed by your doctor.
- Your body needs to rest to accelerate the healing process. You need to lay low as much as possible especially during the rest of the day straight after the operation, then gradually start to do more each day. If your recovery goes well and you feel good, you may return to work and your daily activities about two days after LEEP procedure.
- Place hot water bottle or heating pad over your lower abdomen if you feel abdominal pain.
- Acupuncture helped some patients in their journey back to normal health when recovering from LEEP procedure, so you may want to give it a try.
- Post LEEP follow up visits to your doctor are important, as completion of procedure does not mean it is over. Regular examination and Pap tests are essential after LEEP to evaluate for possible recurrence.
- Contact your doctor as needed if you develop chills and/or fever, have severe abdominal pain, foul smelling discharge or persistent bright red bleeding.
- Stay positive if the physical and emotional impact start to take their toll on you. Hang in there, trust your body’s own ability to heal, and collaborate with doctor closely on your road to recovery.
Recommended read: How to Boost Your Immunity to Fight Recurrent HPV Cervical Dysplasia
Important Restrictions After LEEP Procedure That You Must Not Ignore
There are various restrictions that you need to strictly follow to ensure proper recovery of your cervix. The doctor often outlines what you need to avoid in order to make sure the recovery process is healthy, and free from any complications or infection at this time when the cervix has wounds and requires tissue regeneration.
Here are some of the restrictions after LEEP procedure or things that you need to avoid:
- Avoid douching or use tampons until the discharge is gone or until your doctor tells you it is OK. This prevents damage to the scab that usually forms over the face of your cervix.
- Avoid vaginal intercourse for at least 4 weeks after LEEP.
- Do not take tub bath or sit in hot tub for the first two weeks or until your follow up appointment with your doctor. Shower is fine.
- You should not engage in strenuous activity, such as lifting heavy objects (over 20 pounds).
- Stop tobacco smoking, as studies show cigarette smoking significantly increase the risk of HPV CIN3 and invasive cervical cancer.
Consult your health service provider if you have doubts about these restrictions, and your doctor may give you other instructions after the surgery depending on your specific situation.
These restrictions should all be lifted during your follow up visit to doctor in 4 weeks time after LEEP procedure, and upon examination that confirm your cervix is completely healed.
Exercise After LEEP Procedure: Better Be Safe Than Sorry
It is important for the cervix to stop bleeding and heal properly post LEEP, before any strenuous activities and vigorous exercise, especially when you never know how your body may react in post surgery recovery.
Here are some guidelines of exercise after LEEP procedure, while you should consult the health care provider on your case and exercise routine with specific questions.
- Do not do any vigorous high-impact exercise for at least 1 week – avoid weight lifting, running etc.
- You may start slowly with light activities after 48 – 72 hours, such as doing routine house chores and light gardening.
- You can gradually resume light-intensity exercise after 1 week, such as breeze walking and slow dancing. Take it easy for the first few days with reduced intensity, stop if you feel discomfort.
- If you have more discharge or experience more lower-back / abdominal / pelvic pain after exercise, then lay off a little just to play safe.
- Consult your doctor first before getting back to sports.
What Happens After a LEEP Procedure: Any Risks and Complications?
1. Abnormal Pap / cells may return after a LEEP procedure. While LEEP is proven to be successful in removing precancerous cervix tissues, the U.S. National Library of Medicine revealed a research on 622 cases of CIN LEEP treatment that found 9.1% high-grade CIN recurrence rate within the first 3 years after LEEP procedure.
2. Partial or total Hysterectomy after LEEP may be required if positive endocervical margins found. Researchers in Mahidol University of Thailand studied 407 patients who have undergone LEEP, with 133 of them (32.7%) eventually underwent hysterectomy as the definite treatment for their cervical neoplasia.
3. Pregnancy complications and conception after LEEP is one of the biggest concern among patients, who fear whether the procedure can affect chances of fertility later in life. While you can certainly get pregnant after LEEP, clinical studies published by University Hospital of Northern Norway and BJOG International Journal of Obstetrics & Gynaecology do show LEEP increases risk of pregnancy complications and preterm birth. Another research shows females with a time interval from LEEP procedure to pregnancy of less than 1 year are at increased risk for miscarriage.
Recovery From LEEP / LLETZ Procedure: Summary
The LEEP / LLETZ procedure recovery and post LEEP cervix healing normally take 4 to 6 weeks.
During this time period, especially in the first few days after a LEEP, you may expect to experience vaginal bleeding, pain, cramping, bloating, and brownish or dark discharge with foul smell and blood spots. However, if these signs do not seem to stop, then it’s an indication that something may not right and should be checked out by your doctor promptly.
While aftercare such as take Acetaminophen / Ibuprofen, wear sanitary pad, and ensure sufficient rest can help smooth through your post LEEP recovery —
Do take note on the aforementioned restrictions like avoid douching / tampons / vaginal intercourse for at least 4 weeks, whilst you can slowly resume light-intensity exercise after 1 week.
Stay positive, take care of yourself, and collaborate with doctor on your road to full recovery.
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Have you experienced LEEP / LLETZ procedure? How was your recovery process?
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