Large Loop Excision Transformation Zone (LLETZ)

What is LLETZ?

This treatment aims to remove the abnormal cells found on the surface of your cervix, 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 and repeat treatment may be needed.

What does treatment involve?

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

In most cases LLETZ is carried out in the Colposcopy Clinic, under local anaesthetic (you are awake but the area is numbed, so you feel no pain). Occasionally, it is necessary to carry out the treatment under a short general anaesthetic (you are asleep) in the Day Surgery Unit; this will be discussed with you, should it be necessary.

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).

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, to help with any possible discomfort. You may experience “stinging”/discomfort whilst the local anaesthetic is administered into your cervix. However, this only lasts for a short time, until the local anaesthetic takes effect.

Whilst the abnormal area is removed, you may experience a mild period-like discomfort.

Occasionally patients feel a little faint following treatment, so it is advisable to bring someone with you, who 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 experience 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. However, if your loss becomes excessive or smells unpleasant, you should contact your GP or the Colposcopy Clinic for advice.

• Out of normal working hours (after 5pm and at weekends) if you experience a lot of bleeding, you should go to your nearest accident and emergency (A&E) department.

• Occasionally, 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.

• Please note that some travel insurance companies will not provide you with health insurance following LLETZ procedure. We advise that you check with your insurance company or re-arrange your treatment appointment, if you are going on holiday or flying within six weeks of your treatment date.

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.

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), with a copy sent to your GP.

Will I need to be seen at the clinic again?

You will be given guidance about follow-up when you leave the clinic after your treatment or in your results letter. You may be advised to attend the clinic again or to have more frequent smears taken at your GP surgery.

If you need a further visit to the Colposcopy Clinic, a follow-up cervical smear will be taken and the doctor / nurse specialist will repeat the colposcopy assessment. This is to check that your cervix has healed following treatment and that no abnormal cells remain. If we do find any remaining abnormal cells, it may be necessary to take biopsies or to arrange further treatment. This would be discussed with you at the time.

If you have any questions regarding LLETZ or symptoms following treatment, please contact the Colposcopy Clinic.

Useful telephone numbers

• William Harvey Hospital, Ashford (also for Buckland Hospital patients)
  Colposcopy Secretary: 01233 616700
  Please note the secretary works Monday to Thursday 8am to 4pm

• Kent and Canterbury Hospital, Canterbury
  Colposcopy Suite: 01227 783107

• Queen Elizabeth the Queen Mother Hospital, Margate
  Colposcopy Secretary: 01843 234334