Cone Biopsy or LEEP: What’s the difference?

Cone Biopsy or LEEP: What’s the difference?

What is a Cone Biopsy?

A cone biopsy removes a cone-shaped wedge of abnormal tissue that is high in the cervical canal to be examined under a microscope. 

What is a LEEP Procedure?

The loop electrosurgical excision procedure (LEEP) uses a thin, low-voltage electrified wire loop to cut out abnormal tissue.

How is a Cone Biopsy performed?

A small amount of normal tissue around the perimeter of the site is also removed so that a margin free of abnormal cells is left in the cervix.

How is LEEP performed?

A LEEP can cut away abnormal cervical tissue and remove abnormal tissue high in the cervical canal.

Why is it performed?

The cone biopsy may remove all of the abnormal tissue. This would mean that no further treatment is needed other than follow-up Pap smears. The perimeter of the cervical tissue may contain abnormal cells, meaning that abnormal tissue may be left in the cervix. The cone biopsy may be repeated to remove the remaining abnormal cells. 

Why is it performed?

The physician uses a colposcope to identify the abnormal areas of the cervix. Numbing medication is injected into the cervix with a needle. When the cervix is anesthetized, a small segment at its end is removed with a hot wire shaped in a loop. This wire carries electrical energy to cauterize tissue and reduce bleeding as it passes through. Medication is applied to the cervix to stop the bleeding and promote healing.

What are the risks?

Usually a well-tolerated procedure, excessive bleeding can but rarely occurs. There is a possibility of blood clots in the legs after any procedure.

According to Long-term risks include the reoccurrence of HPV and/or dysplasia, and possibly preterm delivery which is uncommon.

What are the risks?

Heavy bleeding during the first 3 weeks after a LEEP procedure is the most common risk. You may need your OB/GYN Specialist to put more paste on the cervix to stop the bleeding.

Increased risk of premature births and having a low birth weight in the newborn is a risk. Sometimes in rare instances, the cervix may end up more narrow after the procedure which can cause problems with menstruation.  

Cone Biopsy & Follow-up

If follow-up tests show normal cells, then no further treatment may be needed. If abnormal cells remain, other treatments may be required. The cone biopsy may show cancer that has grown deep into the cervical tissue (cervical cancer). Further treatment, such as surgery, radiation, or chemotherapy, will be recommended.

LEEP Recovery & Follow-up

After the procedure, you will need to see your health care professional for follow-up visits. You will have cervical cancer screening to be sure that all of the abnormal cells are gone and that they have not returned. If you have another abnormal screening test result, you may need more treatment.

You can help protect the health of your cervix by following these guidelines:

  • Have regular pelvic exams and cervical cancer screening.
  • Stop smoking—smoking increases your risk of cancer of the cervix.
  • Limit your number of sexual partners and use condoms to reduce your risk of sexually transmitted infections (STIs).
    Source: ACOG

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