Large Loop Excision Transformation Zone (LLETZ)

Information for patients from Women's Health

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

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:

After LLETZ, the opening of the cervix can narrow or close and become scarred. This is called cervical stenosis. If this happens, the passage between the womb and vagina may become partly or fully blocked. Research suggests that this can happen to between 2 and 14 in every 100 patients (2% to 14%). 

You are more likely to develop cervical stenosis if you have:

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?

What do I need to do after treatment?

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

What do you think of this leaflet?

We welcome feedback, whether positive or negative, as it helps us to improve our care and services.

If you would like to give us feedback about this leaflet, please fill in our short online survey. Either scan the QR code below, or use the web link. We do not record your personal information, unless you provide contact details and would like to talk to us some more.

If you would rather talk to someone instead of filling in a survey, please call the Patient Voice Team.