Large Loop Excision Transformation Zone (LLETZ)

You have been referred for a large loop excision transformation zone (LLETZ) procedure. This leaflet:

• explains what LLETZ is

• what the treatment involves, and

• how you may feel after the procedure.

If you have any questions after reading this leaflet, please speak to your doctor.

If you become pregnant after you have had a LLETZ procedure, you must let your midwife know as soon as possible.

What is LLETZ?

LLETZ aims to remove the abnormal cells found on the surface of your cervix. These were found during your recent cervical screening (smear) test / colposcopy assessment.

In 95% of cases (95 out of 100 cases) one treatment is effective at removing the abnormal cells. In 5% of cases (five out of 100 cases) abnormal smears continue despite LLETZ. You may need repeat treatment.

What does treatment involve?

LLETZ treatment involves removing the abnormal area from your cervix. Your doctor does this with a heated wire loop.

In most cases LLETZ is carried out in the Colposcopy Clinic. You are given a local anaesthetic before your procedure, so you are awake but the area is numbed. Occasionally, it is necessary to carry out the treatment under a short general anaesthetic (you are asleep) in the Day Surgery Unit. Your doctor or nurse will discuss this with you.

Are there any risks associated with LLETZ treatment?

The risks associated with LLETZ treatment include:

• heavy bleeding during or after the procedure, and

• infection following the procedure.

LLETZ treatment does not affect fertility (getting pregnant).

If you become pregnant after you have had a LLETZ procedure, you must let your midwife know as soon as possible. There is a small possibility of premature labour, after a LLETZ procedure. This can happen years later, so will need to be monitored by a specialist team.

How long does it take?

LLETZ takes approximately 10 minutes to complete. Most of this time is spent preparing you for the treatment, which only takes a few minutes.

What will I feel?

You may wish to take a mild painkiller (paracetamol or ibuprofen) before your treatment. This will help with any possible discomfort. You may feel “stinging” / discomfort whilst your doctor injects the local anaesthetic into your cervix. This only lasts for a short time, until the local anaesthetic numbs the area.

You may feel a mild period-like discomfort, whilst your doctor removes the abnormal area.

Some patients feel a little faint following treatment. You should bring someone with you to your appointment, so they can drive you home.

What will happen after treatment?

• The local anaesthetic usually wears off after about one to two hours. You can continue to take mild painkillers, as needed.

• You should expect to have some vaginal discharge / bleeding following treatment. The amount of loss varies from woman to woman, but can last for anywhere up to four weeks. The loss may be a watery discharge and / or a light blood loss. If your loss becomes excessive or smells unpleasant, you should contact your GP or the Colposcopy Clinic for advice.

• If you have a lot of bleeding out of normal working hours, you should go to your nearest Emergency Department. Out of normal hours is after 5pm and at weekends.

• Prolonged bleeding can occur. This can sometimes mean you have an infection, which may need treatment with antibiotics. You should ask for advice, as mentioned above.

• Your next period may be heavier than is usual for you.

• Some travel insurance companies will not provide you with health insurance following LLETZ. If you are going on holiday or flying within six weeks of your treatment date, check with your insurance company or re-arrange your treatment appointment.

What do I need to do after treatment?

• Avoid using tampons for four weeks after treatment, to allow the treated area to heal.

• Avoid sex for four weeks after treatment, to allow the treated area to heal and reduce the risk of infection.

• Avoid swimming for two weeks following treatment, to reduce the risk of infection.

• Tell your midwife you have had a LLETZ procedure, during any future pregnancies.

When will I get my results?

We will write to you as soon as your results are available, usually two to four weeks after treatment. Your GP is also be sent a copy.

Will I need a follow-up appointment?

You will be told if you need a follow-up appointment before you leave hospital or in your results letter. Your doctor may advise you to attend the clinic again or to have more frequent smears at your GP surgery.

If you need a further visit to the Colposcopy Clinic, you will have a follow-up cervical smear. The doctor / nurse specialist will repeat the colposcopy assessment. This checks that your cervix has healed following treatment and that no abnormal cells remain. If we do find any remaining abnormal cells, we may need to take biopsies or arrange further treatment. Your nurse or doctor will discuss this with you at the appointment.

If you have any questions before or after your treatment, please contact the Colposcopy Clinic.

Useful telephone numbers

• Colposcopy Secretary
  Telephone: 01233 616700

  Colposcopy Administration Team on behalf of:

  • William Harvey Hospital, Ashford

  • Buckland Hospital, Dover

  • Kent and Canterbury Hospital, Canterbury

  • Queen Elizabeth the Queen Mother (QEQM) Hospital, Margate

   Please note the secretary works Monday to Friday 8am to 4pm