LLETZ is an acronym for Large Loop Excision of the Transformation Zone. It is an operation done to remove abnormal cells from the cervix or the neck of your womb. An electrical current is passed through a thin wire loop that acts like a scalpel which cuts away a thin layer of the cervix
How is the procedure done?
- It is done in the operation theatre and usually under a general anaesthetic
- Preferably, it is done when you are not menstruating to aid the visualisation of the cervix during the procedure. This may not always be possible.
- A speculum is inserted into the vagina and the cervix visualised.
- Local anaesthetic mixed with adrenaline is injected around the cervix. This helps to control bleeding during the procedure.
- An appropriate wire loop size is selected to be used to remove just enough of the abnormal cells and preserve the remaining healthy cervical tissue.
- At the end of the procedure, your doctor will check to ensure there is no bleeding and may apply a brown, pasty substance to help control any bleeding or ooze. Electrocautery, or energy diathermy may also be used to seal any bleeders.
Are there any risks with a LLETZ procedure?
Yes, all surgical procedures carry some risks. These are usually minor. They include:
- Bleeding – this is very common and is usually light bleeding up to three weeks following your procedure. Heavy bleeding may signify an infection. Please call our rooms if this is the case. Out of business hours, please call your GP or present to the Emergency Department at LGH.
- An internal examination will be done with a speculum to look at the source of bleeding
- In most cases, this is easily controlled with a bit of pressure, vaginal packing and some antibiotics at home
- Very rarely, the bleeding is severe, and may need admission and a return to the operating theatre.
- Infection – if you are unwell, have a fever, foul smelling vaginal discharge or chills and shivering, please contact your GP or the Emergency Department at LGH. You may need antibiotics.
- Damage to local tissues – as we are operating in the vagina with an electrical loop, there is a small risk of a small burn injury to the surrounding structures. This is usually minor, but can be quite uncomfortable. Simple painkillers for 24 hours may be all that you need. If there is any bleeding from the accidental contact with the loop, the tissue may require a stitch or two to help stop the bleeding – these stitches are dissolvable.
- Premature delivery in future pregnancies – This is rare after a single LLETZ procedure and most women will have no pregnancy issues.
- It is important that you let your GP / midwife / obstetrician know if you have had a previous excisional operations (i.e. LLETZ or cone biopsy) of your cervix so that an ultrasound assessment of the cervix can be arranged in future pregnancies.
- Cervical narrowing – This may cause problems with adequate menstrual discharge and proper cervical dilatation at the time of labour. This is also rare.
Recovering from a LLETZ
Please do not be alarmed if you experience the following after the procedure:
- Period like cramp
- Blood stained discharge, which can also be quite watery
- Brown coloured discharge – this is from the paste that is used to help control the bleeding at the time of the procedure
While your cervix is healing (can take up to a few weeks), please avoid
- Intercourse for 4-6 weeks
- Using a tampon
- Applying any creams or herbal remedies, unless you are specifically instructed by your doctor
Contact our Rooms / GP / LGH Emergency Department immediately if you experience
- Heavy, prolonged bleeding that is more than a usual period, including any bleeding with clots
- Pain that is severe and not getting better with Panadol, Panadeine or Nurofen
Follow up process post LLETZ
We will see you 6 months after the procedure for a follow up colposcopy and pap smear. This is to ensure your cervix has healed well, and that there are no residual abnormal cervical cells left.
The abnormal cervical cells excised at the time of the operation will be sent for laboratory analysis and our nurse from the Rooms will call you with these results.
You are strongly encouraged to stop smoking to help your healing process and help prevent further abnormalities in your cervix.