Prof. Dr. Derya Sivri AydınObstetrician & Gynaecologist
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LEEP and conization

LEEP and conization remove a cone-shaped piece of tissue containing precancerous changes from the cervix. The procedure treats the changes and, through pathological examination of the removed tissue, confirms their grade.

Written by Prof. Dr. Derya Sivri Aydın
Obstetrician & Gynaecologist, November 2026

When is it done?

  • When a biopsy shows moderate or severe precancerous changes (CIN 2–3)
  • When precancerous changes are found in the glandular cells of the cervical canal (adenocarcinoma in situ)
  • When smear and biopsy results do not match, or the edge of the change cannot be fully seen at colposcopy
  • For some high-grade smear results, in the same session as colposcopy

Mild changes (CIN 1) usually regress on their own and are generally monitored. Under the age of 25, close follow-up may also be preferred for CIN 2.

Techniques

LEEP (LLETZ)

The tissue is removed with a thin wire loop carrying an electrical current. It is usually quick and you go home the same day.

Cold-knife conization

The tissue is removed with a scalpel in the operating theatre under anaesthesia. It may be preferred for glandular lesions or when a deeper sample is needed.

The procedure is performed under local anaesthesia or brief sedation, so that no pain is felt.

After the procedure

  • Light bleeding and brownish discharge for 1–2 weeks are expected.
  • Intercourse, tampons, baths and swimming pools are avoided for a few weeks; showering is fine.
  • See a doctor if you have bleeding heavier than a period, fever, increasing pain or foul-smelling discharge.

Follow-up

Although treatment is effective, the changes may recur or persist in some patients. A check-up with HPV and smear tests is therefore carried out within 6–12 months; once results are normal, regular screening continues for many years. HPV vaccination may be recommended to reduce the risk of reinfection.

Frequently asked questions

Can I have children after LEEP?

Yes. The procedure generally does not affect fertility. However, depending on the amount of tissue removed, the risk of preterm birth in future pregnancies may be slightly increased; cervical length can be monitored during pregnancy.

How soon after the procedure can I get pregnant?

Waiting at least three months is usually recommended to allow the tissue to heal.

What happens if the pathology shows positive margins?

This indicates that part of the change may remain. Depending on the situation, close follow-up, repeat conization or another treatment is planned.

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Prof. Dr. Derya Sivri Aydın sees patients at Medical Park Bahçelievler Hospital, Istanbul. International patients are supported by the hospital's International Patient Services Center.

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The information on this page is for general guidance only; the right diagnosis and treatment for you are decided after a consultation. Last updated: November 2026.

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