Loop Electrosurgical Excision Procedure (LEEP) for Genital Warts

British Columbia Specific Information

Human Papillomavirus (HPV) is one of the most common sexually transmitted infections (STIs). HPV can cause genital warts and cancers of the anus, cervix, mouth and throat, penis, vagina, and vulva. The HPV vaccines protect against infection from certain types of HPV, however, they do not get rid of the infection once it has occurred.

Health Canada has approved 2 HPV vaccines:

Cervarix® (HPV2)
Gardasil®9 (HPV9)

To determine if you are eligible to receive the free vaccine, see HealthLinkBC File #101b Human Papillomavirus (HPV) Vaccines, visit ImmunizeBC – HPV (Human Papillomavirus), or speak with a public health nurse at your local public health unit. Those not eligible for the free HPV vaccine can purchase it at most pharmacies and travel clinics and at some sexual health clinics.

To learn more about HPV infection, see HealthLinkBC File #101a Human Papillomavirus (HPV) Infection and Genital Warts. For more information on STIs, sexual health information, where to get tested and other sexual health services in your area, visit SmartSexResource.

Surgery Overview

The loop electrosurgical excision procedure (LEEP) uses a thin, low-voltage electrified wire loop to remove genital warts by heating the margin of the area to be removed, which separates the wart from the skin.

LEEP is done in a doctor's office, clinic, or hospital on an outpatient basis. A local anesthetic is injected to numb the area.

For women, abnormal cervical cell changes caused by HPV will be managed differently than genital warts caused by HPV. Your doctor may recommend certain types of surgery, such as LEEP. To learn more about surgical methods to treat abnormal cell changes, see the topic Abnormal Pap Test.

What To Expect After Surgery

Recovery time depends on the location and number of warts removed. Most people will be able to return to normal activities within 1 to 3 days after LEEP.

For men and women who have had LEEP, call your doctor if you have any of the following:

Bleeding that lasts longer than 1 week
A fever
Severe pain
Bad-smelling or yellowish discharge, which may point to an infection

Avoid sexual intercourse until the treated area heals and the soreness is gone (usually 1 to 3 weeks, depending on the size of the area treated).

Why It Is Done

LEEP may be used to treat large, external warts and warts on the cervix.

How Well It Works

LEEP may be as effective as other surgeries to remove warts, but scarring may occur.
During LEEP, only a small amount of normal tissue is removed at the edges of the wart tissue.

Risks

Bleeding is the most common side effect. But typically LEEP causes less blood loss than laser treatment.

Scarring of the penis is a possible side effect that can result in problems with urination or erection.

Infection does not occur often and can be treated with antibiotics.

What To Think About

LEEP works best with large, external warts or warts on the cervix.

Treating genital warts does not cure infection with human papillomavirus (HPV), the virus that causes genital warts. The virus may remain in the body in an inactive state after warts are removed. A person treated for genital warts may still be able to spread the infection. Latex condoms may help reduce the risk of HPV infection, but they do not protect the entire genital area against skin-to-skin contact.

The benefits and effectiveness of each type of treatment need to be compared with the side effects and cost. Discuss this with your doctor.

References

Other Works Consulted

Bonnez W (2015). Papillomaviruses. In JE Bennett et al., eds., Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases, 8th ed., vol. 1, pp. 1794–1806. Philadelphia: Saunders.

Credits

Current as of:
February 26, 2020

Author: Healthwise Staff
Medical Review:
Sarah Marshall MD - Family Medicine
Thomas M. Bailey MD - Family Medicine
Adam Husney MD - Family Medicine
Kathleen Romito MD - Family Medicine
E. Gregory Thompson MD - Internal Medicine
Kirtly Jones MD - Obstetrics and Gynecology
Kevin C. Kiley MD - Obstetrics and Gynecology