Dr. Wirth is skilled in the use of advanced diagnostic and treatment techniques, including loop electrosurgical excision procedures for genital warts and abnormal Pap results, to help New York City area women get the best healthcare possible.
Loop electrosurgical excision procedure (LEEP) is a minimally invasive procedure used to remove genital warts or abnormal cells in the cervix so they can be evaluated for cancer or other diseases. The procedure uses a looped, low-voltage electrified wire to remove tissue without the need for invasive surgery.
LEEP is most commonly performed right in the doctor's office as an outpatient procedure. It begins much like your normal exam. You'll lie on your back with your feet in the stirrups and covered from the waist down by a sheet or drape. A lubricated tool called a speculum will be inserted and used to gently widen the vagina so the area can be seen more readily. An anesthetic will be injected into the cervix to numb it and pain medication may also be given orally or through an IV. The LEEP device will be inserted through your vagina and a special instrument called a colposcope can be used to provide a better view to ensure all the cells or wart tissue are removed. Once the tissue is removed, it can be sent to a lab for microscopic evaluation to check for signs of cancer or other medical conditions.
LEEP is performed on an outpatient basis so you can return home the same day. Most women are able to resume their regular activities within one to three days after treatment, depending on the extent of the treatment. In addition, there may be some mild cramping for a day afterward, along with vaginal discharge that can last for about three weeks. Be sure to use pads and not tampons during the healing period and avoid sexual intercourse and douching.
A cervical cone biopsy, sometimes just called a cone biopsy, is a procedure that removes a cone-shaped wedge of tissue from the upper portion of a woman's cervix so it can be evaluated in a lab.
Cone biopsies are used following an abnormal Pap test that indicates moderate to severe changes in the cells of the cervix. It's performed when abnormal cells are too high in the cervix to be adequately evaluated by another diagnostic test called a colposcopy, or when colposcopy doesn't reveal abnormalities indicated by a Pap test. When cervical cancer cells have been found, it may also be used to help determine the extent of the cancer – how far and how deeply it's spread.
Cervical cone biopsy is performed as a same-day procedure, meaning you can go home the same day your biopsy is performed. Before the procedure, you'll be given general anesthesia or the treatment area will be numbed so you won't feel the biopsy as it's performed. A speculum will be inserted to gently widen the vagina so the instruments can access the cervix. The biopsy can be performed using one of several techniques; Dr. Wirth will determine the best technique based on your medical needs and other factors.
Once the procedure is complete, you'll stay in a recovery area for a few hours for observation. You can expect some vaginal bleeding for about a week and additional discharge for another two weeks. You'll need to use pads and not tampons during the three-week period after your procedure, and you'll also need to avoid sexual intercourse and douching during that time. Most women find they can resume their regular activities within a week.