LEEP and cone biopsy are surgeries used to treat cervical dysplasia. LEEP removes cells from the surface of the cervix, while cone biopsy removes a wedge-shaped piece of tissue further up the cervical canal. Both surgeries require widening of the vaginal canal and examination of the cervix under a microscope. Recovery involves mild cramping and bleeding, and avoiding sex and heavy physical activity for four to six weeks.
The difference between a loop electrosurgical excision (LEEP) procedure and a cone biopsy is based on the amount of cervical tissue removed and the method of excision. Both surgeries could be done with the same surgical tool, but the LEEP and cone biopsy involves removing tissue from different areas of the cervix. LEEP removes cells from the surface of the cervix, while a cone biopsy removes a wedge-shaped piece of tissue further up the cervical canal. Another difference between these procedures is that one is performed in a doctor’s office and the other in a hospital.
Both LEEP and a cone biopsy, called a conization, are used to treat cervical dysplasia, a condition characterized by abnormal cells in the lower part of the uterus. The abnormal cervical cells might change and invade beyond the surface of the cervix, where they can mutate into cancerous cells. A cone biopsy removes tissue containing cells that have invaded the upper regions of the cervix. A LEEP device can be used for this but is more often used for superficial dysplasia. Some doctors prefer a scalpel or laser surgery when performing the conization.
A woman undergoing a cone biopsy might receive general anesthesia during the procedure or local anesthesia to numb the vaginal area. LEEP typically requires simple numbness of the cervix. This is the only difference between LEEP and cone biopsy during the preparatory phase.
In both cases, the vaginal canal is widened to allow the doctor to see the cervix. A vinegar or iodine solution is applied that turns the dysplasia cells white and guides the doctor in removing the abnormal tissue. He or she uses a special microscope that shines a strong light and high magnification on the cervix during both types of surgery. Any tissue removed from either procedure is sent to a lab for examination.
An abnormal Pap smear usually requires both procedures. This test identifies dysplasia that may appear mild, moderate, or severe before it becomes cancer. Women who are carriers of the human papillomavirus (HPV) that causes genital warts are at increased risk of developing dysplasia. HPV is a sexually transmitted disease and the most common cause of dysplasia. There is also a higher risk for women with multiple sexual partners, women who started having sex before age 20, and smokers.
The recovery period from these procedures is the same. After both surgeries, you may experience mild cramping and bleeding, and rest for a day or two is recommended. Sex and heavy physical activity should be avoided for four to six weeks, along with tampon use. Medical professionals typically recommend more frequent pap smears in the first year after LEEP and cone biopsy to determine if all suspicious cells have been removed.
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