LLETZ Procedure
An LLETZ biopsy is performed to remove pre-cancerous cells from the cervix, to prevent these cells from developing into cancer in the future. Usually, it is used for high-grade precancerous cells (cervical intraepithelial neoplasia, CIN grades 2 and 3 or HSIL).
It is a Loop Excision of the Transformation Zone
The abnormal area is removed using a fine wire loop; a small electric current is passed through the loop. The cells are sent to a specialist pathologist for detailed testing.
LLETZ is a very safe procedure to remove abnormal cells, which have the risk of transforming into cancer in the future.
About 5 in every 100 women may have complications of:
- infection (which can be treated with antibiotics)
- bleeding usually on day 12 after the procedure
- not all the abnormal cells being removed
- scarring on the cervix or cervical stenosis which stops menstrual blood from coming out of the uterus and requires a procedure to remove scarring
Rarely the procedure can cause a scar on the cervix which may make taking a smear more difficult in the future.
It is important to tell your obstetrician that you have had an LLETZ procedure, because you may need to be monitored more closely. You may have to have the length of the cervix to be checked with ultrasound during pregnancy regularly and very rarely some women require to put a stitch on the cervix to prevent miscarriage or preterm birth. This is because there is a very small risk of your waters breaking or you going into labour early. Most women who have had an LLETZ procedure have normal healthy pregnancies and babies. Research shows that having an LLETZ procedure does not make it more difficult to become
pregnant.
LLETZ procedures are usually carried out under a general anaesthetic as a day case procedure or under local anaesthetic (you are awake). If you have a general anaesthetic you will need someone to take you home and stay with you for the first 24 hours after the procedure.
A local anaesthetic will be used to numb your cervix, then the doctor will use a colposcope to see a magnified view of your cervix and a fine wire loop is used to remove the abnormal area.
It usually takes about 15 minutes to complete the procedure.
Usually, women don’t feel unwell following this procedure, commonly women have a day off work, we can provide a medical certificate if you need one
You may experience some crampy discomfort similar to period pain, you can take medication that you would normally use e.g. anti-inflammatories such as ibuprofen. It is normal to have some vaginal bleeding/ brownish discharge for up to 3 weeks. The healing process takes up to 3 weeks, during this time you are advised to:
- not use tampons (sanitary pads are best)
- not have sexual intercourse
- avoid hot bath
- avoid spas or hot pools
- avoid vigorous exercise (normal day to day activity and walking are fine)
CALL Dr Novikova If you experience any of the following:
- heavy vaginal bleeding (which is bright red)
- severe pain
- a high temperature – above 37.8°C
- vaginal discharge which is heavy or smelly
Bleeding may be slight or as much as a heavy period initially.
- The cervix takes three to three weeks to heal and you may have a heavy discharge
during this time. - For 4 weeks avoid
- the use of tampons [to encourage healing and help prevent infection].
- intercourse [which could cause further bleeding]
- heavy exercise like
- swimming pools and spas. You can have showers
- You will be given a follow-up date with Dr Novikova
- You will also be advised to have another appointment at 6 & 12 months following
the LLETZ procedure for a repeat Pap smear and HPV test - You will then require yearly Pap smears
5 – 10 % of abnormal [dysplastic or pre- cancerous] cells become cancerous later in
life. It is therefore very important for you to have yearly smears to pick up any
abnormal cells well before any cancer occur.