LEEP in the family practice setting

J Am Board Fam Pract. May-Jun 2003;16(3):204-8. doi: 10.3122/jabfm.16.3.204.

Abstract

Background: We wanted to review our 7-year experience using the loop electrical excision procedure (LEEP) for the treatment of cervical dysplasia in a family practice residency setting in the rural South.

Methods: We conducted a retrospective study with data gathered from chart review of a mostly Medicaid and uninsured patient population of rural Southern women referred from outlying health departments or private practices within an 80-mile radius. The women received follow-up Papanicolaou smears, and outcome measurements were either recurrence of dysplasia or at least 1 year with two negative Papanicolaou smears. Any surgical tissue obtained after LEEP was used to ascertain residual or recurrent dysplasia.

Results: Rates of disease recurrence and incomplete excision of cervical intraepithelial neoplasia grade 2/3 (CIN 2/3) compared favorably with results published by expert US gynecologists but were worse than those reported by European authors, who excise all CIN (CIN 1, CIN 2, and CIN 3).

Conclusion: CIN 2 and CIN 3 can be diagnosed and treated appropriately with LEEP in the setting of a family practice residency.

MeSH terms

  • Adult
  • Cervical Intraepithelial Neoplasia / surgery*
  • Electrocoagulation*
  • Family Practice
  • Female
  • Humans
  • Recurrence
  • Retrospective Studies
  • Uterine Cervical Dysplasia / surgery*
  • Uterine Cervical Neoplasms / surgery*