LLETZ (also called loop electrosurgical excision) is a minor procedure to remove abnormal cells from the cervix (the entrance to the womb). It aims to prevent cervical cancer by treating precancerous changes (CIN) caused by high-risk human papillomavirus (HPV).
This procedure is quick and effective – takes 10–15 minutes, usually under local anaesthetic and does not affect your ability to have children.
Why is LLETZ Performed?
Your gynaecologist may recommend LLETZ if:
- Your cervical screening (smear test) or colposcopy showed high-grade cell changes (CIN2/3).
- Abnormal cells are confined to the cervix (not cancer).
- You want to avoid further progression of cell changes.
Before the Procedure
- Consultation: Discuss risks, benefits, and alternatives options
- Pre-checks:
- Pregnancy test (if there’s any chance you could be pregnant).
- Review medical history/allergies.
- Preparation:
- No fasting (eat and drink normally unless advised otherwise).
- Avoid for 24 hours: Vaginal sex, tampons, or creams.
- Arrange transport: If anxious, ask about sedation (you may need someone to drive you home).
During the Procedure
- Positioning: You lie on a couch, like during a smear test.
- Speculum: A smooth plastic tool gently opens the vagina to view the cervix.
- Local anaesthetic: Injected to numb the cervix (may feel a brief sting).
- LLETZ process:
A thin wire loop with an electrical current removes the abnormal area.
The tissue is sent to a lab for testing. - Completion: A solution may be applied to stop bleeding.
What you might feel:
- Mild cramping or warmth during the procedure.
- Pressure from the speculum.
Risks and Complications
- Common (temporary):
- Light bleeding/discharge (brown or pink) for 2–4 weeks.
- Mild cramping (similar to period pain).
- Rare but serious:
- Heavy bleeding (soaking >1 pad/hour).
- Infection (fever, foul-smelling discharge, severe pain).
- Narrowing of the cervix (stenosis – rare, may affect future fertility).
- Slightly increased risk of preterm labour in future pregnancies.
Recovery and Aftercare
- Immediately after:
- Rest for 30 minutes; most go home the same day.
- Use sanitary pads (no tampons) until bleeding stops.
- Self-care:
- Avoid sex, swimming, or baths for 4–6 weeks (to reduce infection risk).
- Take paracetamol/ibuprofen for cramps.
- Return to work: Most resume normal activities within 1–2 days.
Follow-up Care
- Results: Discuss lab findings at a 2–4 week follow-up.
- Cervical screening:
- Repeat smear tests and HPV checks every 6–12 months until normal.
- Attend routine screening as advised (even after treatment).
Frequently Asked Questions
Q: Will it hurt?
A: Most feel mild discomfort. Local anaesthetic minimises pain.
Q: Can LLETZ affect my fertility?
A: No – the cervix heals, and fertility is preserved. Future pregnancies are usually unaffected.
Q: Will abnormal cells return?
A: Possible (5–15% risk). Regular screening helps detect changes early.
Q: How soon can I try for a baby?
A: Wait until fully healed (4–6 weeks). Discuss plans with your gynaecologist.
eGynaecologist Advice
- LLETZ is a preventative treatment – catching and treating cell changes early helps stop cervical cancer and you must not delay this treatment if advised by your gynaecologist
- You should seek urgent gynaecological consultation if you notice heavy bleeding, raised temperature >38°C, or severe pelvic pain following the LLETZ procedure
