Uzm. Dr. Ertan Özen
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- 36+years exp.
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Gynaecological Procedures
Leep
What LEEP is, how a thin electrified wire loop removes abnormal cervical tissue after a colposcopy, who needs it, how it differs from cone biopsy, laser and ablation, approximate costs in Turkey against the UK, US and Germany, what recovery and follow-up involve, risks including pregnancy, and how to check a gynaecology clinic.
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Prof. Dr. Zehra Neşe Kavak
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LEEP in Turkey: what the procedure is and how it works
LEEP (loop electrosurgical excision procedure, called LLETZ in the UK) removes abnormal cells from the cervix, the neck of the womb. A thin wire loop carries a low-power electric current that cuts and seals as it passes through the tissue, so the surgeon can shave away the area of abnormal cells in one pass, together with a small margin of healthy tissue. The piece removed is sent to a laboratory, which confirms the diagnosis and checks that the edges are clear. LEEP is both a treatment and a test, and it is done as an outpatient procedure in gynaecology clinics and hospitals in Turkey.
It is used after a screening test and a colposcopy (a magnified look at the cervix) have shown precancerous change known as cervical intraepithelial neoplasia (CIN), or high-grade squamous intraepithelial lesion (HSIL). It is not a treatment for cervical cancer. This guide explains who needs it, what happens, what it costs compared with the UK, US and Germany, and what to know about recovery, risks and pregnancy.
When do you need a LEEP?
A LEEP is generally advised when a colposcopy and biopsy show moderate or severe cell change (CIN 2 or CIN 3), or when low-grade change persists and the specialist advises treatment. A second reason is when a colposcopy cannot see the whole abnormal area, or when the biopsy and the screening test do not match. Mild change (CIN 1) very often clears by itself and is typically monitored rather than treated.
The question of whether to travel is separate from the medical one. You need the colposcopy and biopsy reports, the smear or HPV result, and the dates. A clinic in Turkey will normally review these before agreeing to treat, and in some cases will repeat the colposcopy on arrival. If you are in a national screening programme, tell your own doctor about any treatment abroad so that your follow-up tests stay on schedule.
Does LEEP work?
Yes, for most women. Excising the abnormal area removes the cells that could develop into cancer, and large studies show that treatment prevents most cases from progressing. A single procedure clears the abnormal cells in the large majority of women, but not everyone: if abnormal cells reach the edge of the tissue removed, or if high-risk human papillomavirus (HPV) persists, the problem can recur and further treatment or closer monitoring is needed. That is why a follow-up test, called a test of cure, is part of the treatment.
LEEP does not remove HPV itself. The virus usually clears by itself over time, and HPV vaccination is recommended where it is still relevant. A clinic that tells you a LEEP "cures HPV" is oversimplifying.
What happens during a LEEP, step by step?
You lie as for a smear test. A speculum is inserted, the cervix is painted with a dilute vinegar or iodine solution to show the abnormal area, and local anaesthetic is injected into the cervix. A grounding pad is placed on your thigh. The surgeon then passes a loop, chosen to fit the size of the abnormal area, through the tissue; this takes a few seconds. The base is sealed with a ball-shaped electrode or a medicated paste to stop bleeding. The procedure takes about 10 to 20 minutes, and you go home the same day, usually after an hour or two of rest. General anaesthetic or sedation is available in some clinics, for example when the abnormal area is large or the patient is anxious.
Does LEEP hurt?
The injection can sting and you may feel pressure, a tugging sensation or period-type cramps during the cut. Most women describe it as uncomfortable rather than very painful, and it passes quickly. Cramps and a dull ache can continue for a day or two, helped by simple painkillers such as paracetamol or ibuprofen if you can take them. If you are very anxious or have had pain with smear tests, ask about sedation beforehand.
LEEP cost in Turkey compared with the UK, US and Germany
The figures below are approximate ranges for private treatment, not hospital quotes. In the UK the procedure is free on the NHS after an abnormal screening, so comparison applies to private care. Each hospital confirms its price in writing.
| Country | Approximate private cost |
|---|---|
| Turkey | €250 – €1,000 |
| United Kingdom | €900 – €2,500 |
| United States | €1,200 – €4,000 |
| Germany | €600 – €2,000 |
The price depends on whether a colposcopy is repeated, the type of anaesthesia, the laboratory examination of the tissue (histology), a hospital or clinic setting and follow-up visits. Ask whether histology, the first review and a copy of the report in English are included. A package for a short procedure is not complicated; the main point to check is that the pathology result is reported to you properly.
LEEP, cone biopsy or laser: which excision method is used?
Several techniques remove or destroy abnormal cervical tissue. LEEP is the most widely used because it is quick, can be done under local anaesthetic and yields a tissue sample. Larger or deeper abnormalities may need a different approach. See our guides to conization and cervical conization (cone biopsy) for the surgical alternatives.
| Method | Suited to | Typical limits |
|---|---|---|
| LEEP | Most CIN 2 and CIN 3 lesions on the outer cervix | Heat can affect the edge of the sample; deeper canal lesions may need a cone |
| Cold knife cone biopsy | Larger or deeper lesions; glandular abnormalities | Usually under general anaesthetic; more bleeding; larger tissue loss |
| Laser conisation | Precise excision in selected cases | Needs a laser and training; availability is limited |
| Ablation (cryotherapy, thermal) | Small, fully visible lesions where a sample is not needed | No tissue is sent for examination |
Your gynaecologist should explain why a particular method fits your colposcopy findings. If a diagnostic hysteroscopy or investigation of the womb lining is also needed, see hysteroscopy.
What is LEEP recovery like?
Most women go back to desk work the next day or after a couple of days. Expect a watery, pink or brownish discharge and light bleeding for up to three to four weeks, sometimes with a darker, coffee-ground look as the area heals. Use pads, not tampons, and avoid sex, swimming and baths for about four weeks, or as advised, to lower the chance of infection or bleeding. Avoid heavy lifting and strenuous exercise for about a week or two. A heavier bleed can occur about a week or two after the procedure when the scab separates.
Contact a doctor if you have bleeding that soaks a pad within an hour, fever, severe abdominal pain or foul-smelling discharge. Because these can happen after you travel, agree beforehand who you would see at home, and carry a letter and your pathology report. Flying is generally acceptable once the surgeon confirms you are well; for a LEEP alone, a stay of two to three days is usual.
What are the risks of LEEP, including for pregnancy?
Common effects are cramping, spotting and discharge. Less common problems are bleeding that needs treatment, infection, and narrowing of the cervical canal (stenosis), which can alter periods or make later smear tests harder to take. The most discussed long-term issue is pregnancy: excision of a larger or deeper piece of the cervix is associated with a small increase in the risk of preterm birth and late miscarriage in later pregnancies. The risk rises with the depth removed, which is why surgeons aim to remove only what is needed. Larger studies and guidance from the NHS, the Royal College of Obstetricians and Gynaecologists and the American College of Obstetricians and Gynecologists describe this link, while stressing that most women go on to have healthy pregnancies. Tell your obstetrician about a previous LEEP.
Who should avoid or delay a LEEP?
A LEEP is usually delayed if you are pregnant, have an active pelvic infection, or are bleeding heavily for another reason. If the colposcopy raises concern about cancer or glandular change, a cone biopsy or specialist review is more suitable than a LEEP. Women who plan pregnancy soon should discuss the smallest effective excision, and anyone who takes blood-thinning medicine should tell the surgeon. Your gynaecologist should review your history before agreeing to treat.
How do I choose a clinic, and what should I ask?
Look for a gynaecologist with colposcopy training, a clinic that asks for your screening and biopsy results, a laboratory that reports in a language you understand, and clear follow-up arrangements. Red flags include treatment offered without a colposcopy or biopsy, promises that the procedure cures HPV, no histology report, a very low price that omits the laboratory examination and pressure to book at once. Read how our process works and send your reports through the free quote page. For wider options see our gynecology treatments in Turkey.
- Do you need my colposcopy and biopsy report before treating me?
- Is the tissue sent for histology, and when will I get the report in English?
- How much of the cervix is likely to be removed?
- Which anaesthesia do you use, and is sedation available?
- Who do I contact if I bleed or have a fever after I get home?
- When should my test of cure be done and who will arrange it?
Hospitals with Gynaecology in Turkey
Frequently asked questions
LEEP, or loop electrosurgical excision procedure, removes abnormal cells from the cervix using a thin wire loop carrying a low-power current. It is done as an outpatient procedure, usually under local anaesthetic, and the tissue is sent for laboratory examination.
It is usually advised when a colposcopy and biopsy show moderate or severe cervical cell change (CIN 2 or CIN 3), or when low-grade change persists. It treats precancerous cells to stop them developing into cancer.
You may feel a sting from the injection, then pressure or period-type cramps for a few seconds. Most women find it uncomfortable rather than very painful. Cramping can continue for a day or two and is helped by simple painkillers.
Approximate private costs are €250 to €1,000 in Turkey, against about €900 to €2,500 for private treatment in the UK. Ask whether the laboratory report and follow-up are included. Hospitals confirm prices in writing.
Most women return to normal activities within a day or two, though discharge and light bleeding can last three to four weeks. Pads, not tampons, are advised, and sex and swimming are avoided for around four weeks.
No. LEEP removes abnormal cervical cells but does not remove the virus. HPV usually clears by itself over time, and a follow-up test after treatment checks that the abnormal cells and high-risk HPV have gone.
Yes, most women conceive and have healthy pregnancies. Removing a larger piece of the cervix is linked to a small increase in preterm birth risk, so tell your obstetrician about the treatment.
Common effects are cramps, spotting and discharge. Less often there is heavier bleeding, infection or narrowing of the cervical canal. A small increase in preterm birth risk is described after deeper excisions.
LEEP is a form of cervical excision using an electrified loop, while a cold knife cone biopsy uses a scalpel and is more often reserved for larger or deeper abnormalities. Your gynaecologist chooses based on the colposcopy findings.
Two to three days usually cover the consultation, the procedure and a short check afterwards. Your follow-up test of cure is normally arranged with your own doctor several months later.
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