HPV treatment

Colposcopy and LEEP: what to expect step by step

LEEP — also called LLETZ in the UK — is the most common treatment for high-grade cervical changes. Understood properly, it is quick, effective and fertility-safe.

Op. Dr. Berra Önsoy — Consultant Obstetrician & Gynaecologist
Medically written & reviewed by
Op. Dr. Berra Önsoy · Consultant Obstetrician & Gynaecologist
Istanbul, Turkey · 29 years of clinical practice · 8 min read · Consults in English & Turkish

Istanbul University Cerrahpaşa (English) MD, 1997. Ob-Gyn residency at Taksim Training & Research Hospital (2001). Private practice in Istanbul focused on endometriosis, myoma surgery, high-risk pregnancy and aesthetic gynaecology.

Clinical focus
  • Endometriosis surgery
  • Myoma (fibroid) surgery
  • High-risk pregnancy
  • Aesthetic gynaecology
  • HPV & colposcopy
Last medically reviewed: 15 January 2026View full clinical credentials·Verify on:drberraonsoy.cominstagram.com
Key takeaways
  • LEEP/LLETZ removes the abnormal area in a single 10–15 minute session.
  • Cure rates after one procedure are around 90–95%.
  • Fertility is preserved when depth is tailored appropriately.

What LEEP/LLETZ actually is

LEEP (Loop Electrosurgical Excision Procedure) — called LLETZ in the UK — uses a fine heated wire loop to remove the abnormal area of the cervix in one thin slice. The removed tissue goes to the lab as a definitive biopsy, so treatment and diagnosis happen in one step.

The procedure takes 10–15 minutes under local anaesthetic. Most women are back at work the next day, with light bleeding and a watery discharge for 2–3 weeks.

How well it works

A single LEEP clears high-grade CIN in around 90–95% of women. Follow-up is with an HPV test at 6 months (the 'test of cure'). If that is negative, screening usually goes back to routine intervals.

Fertility and pregnancy after LEEP

A single, appropriately sized LEEP has minimal effect on future fertility or full-term pregnancy. Very deep or repeated excisions (>10–15 mm) can slightly increase the risk of preterm labour, which is why depth is decided carefully at the time.

If you are planning pregnancy, tell your colposcopist — the depth of the loop is tailored to remove what is needed and no more.

Frequently asked questions

Does LEEP hurt?

Most women feel pressure, not pain. Local anaesthetic is injected first; period-like cramping afterwards settles within a day.

Can I try for pregnancy after LEEP?

Yes, usually after 3 months of healing.

Will I need another LEEP?

Around 5–10% of women need a second procedure if margins are involved or HPV persists.

Could a doctor-led plan help you?

A 30-minute video consultation with Dr Berra Önsoy — reviewing your test results and giving you a clear, personalised next step.

Request a video consultation

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