What should you know about LEEP with top hat?

LEEP, also called LLETZ, uses a thin heated wire loop to remove abnormal tissue from the cervix. The top-hat part is a second, smaller pass that reaches into the cervical canal. A clinician may suggest it when the abnormal area extends upward, the first sample does not show its full upper edge, or a clearer tissue assessment is needed. The removed tissue is sent for examination, which helps determine whether abnormal cells were fully removed and whether further care is needed.

The procedure is usually planned after a colposcopy, where the cervix is viewed closely. A colposcope stays outside the body; it magnifies the cervix while tissue is sampled or treated.

Follow the clinic's instructions about medicines, eating, and arranging transport if sedation is planned. Tell the team about pregnancy possibility, bleeding problems, allergies, and medicines that affect clotting. Afterward, mild cramping and watery, brown, or blood-stained discharge can occur as the cervix heals. Use pads rather than internal menstrual products while advised, and avoid vaginal sex or swimming for the period your clinician gives you. Keep the follow-up appointment so the tissue result and future cervical checks are explained.

Contact your clinic promptly for bleeding that is heavy or increasing, severe pelvic pain, fever, faintness, or discharge with a strong unpleasant smell. These symptoms can signal a complication or infection and need assessment. Seek urgent help if you feel very unwell, collapse, or cannot control the bleeding.

Ask why a top-hat sample is recommended, how much tissue may be removed, when the result should be available, and which symptoms should prompt an urgent call. You can also ask how the result may change follow-up, pregnancy planning, or the possibility of a cone biopsy.