I just had a LEEP [loop electrosurgical excision procedure] performed, after colposcopy and a biopsy confirmed moderate cervical dysplasia. I was surprised by the size of the piece of my cervix that was removed. Does this tissue actually grow back and form a normal-sized cervix again, or does it simply "heal over," leaving me with a smaller cervix? If it doesn't grow back, are there any consequences to having a smaller cervix?

--S.R.

A LEEP is a minor surgical procedure to remove the abnormal portion of the cervix and often the entire transformation zone -- the part most vulnerable to the effects of infection (from HPV, the human papilloma virus) and trauma. The area heals but does not regrow. Potential consequences of a LEEP are scarring or an incompetent cervix.

Scarring may cause the cervical canal to close, trapping menstrual blood inside the uterus and producing pain and increasing the possibility of developing endometriosis. This, in turn, can lead to infertility. This scarring is treated by dilating the cervix, which is easy and effective.

Cervical incompetence is the opposite problem -- the cervix does not stay closed during a pregnancy. It dilates painlessly and, if not diagnosed and treated appropriately, can lead to a second-trimester miscarriage. When doctors believe cervical incompetence may be a problem, they may place a stitch in the cervix, called a cerclage, at about 14 weeks into the pregnancy. This is very effective in preventing pregnancy loss.

However, most women who have had a LEEP have absolutely no problems. If you stop having periods or if they become much more crampy, be sure to tell your doctor so she can check for stenosis (scarring that narrows the opening). If you become pregnant, you will also need to tell your doctor that you have had a LEEP. Cervical exams or ultrasound may be done to make sure that your cervical length is good and that there is no sign of weakness.