LLETZ

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 (e.g., laser or cryotherapy).
• 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

1. Positioning: You lie on a couch, like during a smear test.
2. Speculum: A smooth plastic tool gently opens the vagina to view the cervix.
3. Local anaesthetic: Injected to numb the cervix (may feel a brief sting).
4. LLETZ process:
   1. A thin wire loop with an electrical current removes the abnormal area.
   1. The tissue is sent to a lab for testing.
5. 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.

Seek urgent help if you experience:

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