The
“We treat people, not
just problems.”
John
L. Pfenninger, M.D.
(989) 631-4545
Visit our
website at: MPCenter.net
In 1991, a
new treatment was found to remove precancerous conditions of the cervix, vulva
(lips), vagina, and anus. This procedure
actually uses radiofrequency waves to remove tissue. The waves are a type of electricity that is
similar to the AM radio. It is confusing
even for me to understand exactly how it works, but it does! The radio waves actually cause less
destruction of tissue than does the electrical current, which was used in the
past. This procedure is replacing most
operating room and laser surgeries.
As you
know, you have an abnormality on your cervix.
In the past, many of these were treated with freezing (cryosurgery) or
conization (a way of cutting out the abnormality) in the hospital. Many of your friends have probably told you
about that. The advantages of the LEEP
procedure is that it is very effective for treating advanced lesions or very
large lesions on the cervix, and it can be done in the office. The same equipment can also be used to remove
growths you can see on the genital area.
When you
come in for the LEEP procedure, you will be placed in stirrups, just as you are
for a Pap smear. The vaginal speculum
will be placed. You will be stained with
vinegar and examined with the colposcope (essentially a magnifying glass). Iodine will be placed on the cervix to
further help identify the abnormal tissue.
The cervix will then be numbed with Xylocaine—just like you receive in
the dentist's office. Using a thin wire
loop, the doctor will remove the abnormal tissue. You will hear a lot of noise from a vacuum
that removes the smoke. Although a half hour is set up for your
appointment, the procedure itself only takes 8-10 minutes.
The complications from LEEP are rare. We have done perhaps 600 procedures and only
2 or 3% have significant problems.
·Pain and discomfort. This is minimal. A study in our office showed that on a scale
of 1-10 where 10 is severe pain, women only rated the pain a 2. It is not bad at all. What didn’t they like? The speculum in the vagina and the shot to
numb the area. You really will not feel much else. Afterwards, there may be slight cramping for
24 hours, but that is minimal. Take (4)
200 mg (total of 800 mg) ibuprofen tabs an hour before coming in and then
take (3) tabs four hours later. That may
be all you need. Do not take any aspirin
products, since that may make you bleed.
·Bleeding.
You will have some spotting for 8-10 days. When the “scab” comes off in 10-14 days, you
may notice a little more bleeding. If you pass large clots, more than you have
with your periods, or are concerned, call us.
You may also pass some “black stuff” that looks like tissue but it is
the medicine we use to control bleeding.
Do not worry about that.
·Infection.
This is rare but can happen. You
may have a slight discharge. If it lasts over two weeks, call us. Also, if you have a fever or experience
severe pain in the lower abdominal area, call.
·Recurrence.
We may miss some of the abnormality, or it may come back. Be sure to keep your follow-up appointments.
·Stenosis.
This means the opening of the cervix scars shut. We must keep it open in order for you to get
Pap smears, to have periods, and to get pregnant. There is no way to know if this happens
unless the doctor rechecks you. Keep
your appointment in 6 weeks for this exam.
If found early, it is easy to place a small probe to open it up.
Take (4) 200 mg ibuprofen (Advil, Nuprin or Motrin,
etc.) 1 hour before your appointment to help ease any discomfort. Schedule your appointment anytime after your
period but at least 5 days before your next expected period.
The real advantages of LEEP are that it is quick, has a high cure rate with
the first treatment, and is much cheaper than laser or operating room
procedures. In fact, it has almost replaced all the old procedures
completely. Studies show that it does
not interfere with getting pregnant or having a baby unless repeat procedures
are performed.
After the LEEP is carried out, please follow these instructions:
·
Refrain
from sex for 2-3 weeks.
·
Avoid
lifting heavy weights for 3 weeks (limit to less than 20 lbs.).
·
A
brownish-black vaginal discharge for a few days to two weeks is normal. However, if a malodorous (smelly) discharge
develops, use a vaginal douche with (1/2 vinegar and 1/2 water) twice a day for
5 consecutive days. If the odor or
discharge persists, please call our office.
·
If
spotting or bleeding persists longer than two weeks, call the office.
·
If
you develop bleeding with clots, call the office anytime.
·
Return to our office in six weeks for a brief check. In 4, 8, and 12 months, you will need
follow-up Pap smears either in our office or your doctor's office. We will let you know.
Remember that, even though you have
been treated, you still have an increased lifetime risk of developing cervical,
vaginal, and vulvar cancer. You and your
partner definitely must refrain from
smoking. To prevent spread of the
wart virus, all major authorities recommend monogamy—having sex with the same
partner for the rest of your life.
Although condoms and non-oxynol 9 spermicidal jelly may help prevent the
spread of warts, they are not totally protective. Even after the three follow up Pap smears
mentioned above are normal, you must obtain a Pap smear at least once a year
for the rest of your life to screen for cervical cancer. A healthy diet with at least five portions of
fruits or vegetables each day is essential.
It may also be beneficial to take a good multivitamin with folic acid
each day.
Please feel free to ask if you have
any further questions or desire further information. Videotapes
discussing many of these issues are available for your home viewing.
Copyright, 2011.
John L. Pfenninger, M.D. jw02/11