LEEP and CNC are two different procedures used to excise or remove abnormal cells from the cervix. These procedures are usually recommended when a patient has a PAP with HGSIL (high grade intraepithelial neoplasia) or when the cervical biopsy shows CIN 2 or 3 (moderate to severe dysplasia or pre-cancer).

LEEP stands for loop electrosurgical excision procedure and is usually an office procedure used to remove the abnormal tissue/cells on the cervix. A small wire loop with electricity through it is used as the cutting tool facilitating removal of a small thin piece of skin from the surface of the cervix. The tissue can then be sent to pathology as a biopsy and can show if all the abnormal cells were removed. This procedure is well tolerated in the office and is not painful. Numbing medicine is used during the procedure and the entire procedure takes less than 15 minutes.

CNC stands for cold knife cone and is another way of removing the abnormal cells on the cervix allowing for new healthy cells to grow back. This procedure is usually done in the operating room under anesthesia. Patients with higher grade pre-cancer or involvement of the cervical canal may be better suited for this procedure. The procedure is similar to a LEEP but the cutting tool to a scalpel. The length of the procedure is about 15 - 30 minutes and the recovery is quick.

After the procedure, patients may experience some pelvic cramping and spotting for a few days to a week. Usual activities may be continued immediately afterwards other than sex. Most times patients will experience a watery discharge after the procedure until the skin has healed over, which lasts about 3 weeks. Once this discharge resolves, patients can resume sexual activity.

Patients experiencing heavy bleeding, increasing pain, fevers, or other problems after the procedure should contact their physician immediately. Most patients tolerate the procedure very well and do not experience any difficulties afterwards. Patients should follow-up for repeat PAPs as recommended by their doctor, usually in 4 - 6 months post LEEP or CNC.

ACOG, " Loop Electrosurgical excision procedure" AP110