LLETZ

LLETZ (also called loop electrosurgical excision) is a minor procedure to remove abnormal cells from the cervix (the entrance to the womb). It aims to prevent cervical cancer by treating precancerous changes (CIN) caused by high-risk human papillomavirus (HPV).

This procedure is quick and effective – takes 10–15 minutes, usually under local anaesthetic and does not affect your ability to have children.

Why is LLETZ Performed?

Your gynaecologist may recommend LLETZ if:

• Your cervical screening (smear test) or colposcopy showed high-grade cell changes (CIN2/3).
• Abnormal cells are confined to the cervix (not cancer).
• You want to avoid further progression of cell changes.

Before the Procedure

• Consultation: Discuss risks, benefits, and alternatives options
• Pre-checks:
  • Pregnancy test (if there’s any chance you could be pregnant).
  • Review medical history/allergies.
• Preparation:
  
  • No fasting (eat and drink normally unless advised otherwise).
  • Avoid for 24 hours: Vaginal sex, tampons, or creams.
  • Arrange transport: If anxious, ask about sedation (you may need someone to drive you home).

During the Procedure

• Positioning: You lie on a couch, like during a smear test.
• Speculum: A smooth plastic tool gently opens the vagina to view the cervix.
• Local anaesthetic: Injected to numb the cervix (may feel a brief sting).
• LLETZ process:
  A thin wire loop with an electrical current removes the abnormal area.
  The tissue is sent to a lab for testing.
• Completion: A solution may be applied to stop bleeding.

What you might feel:

• Mild cramping or warmth during the procedure.
• Pressure from the speculum.

Risks and Complications

• Common (temporary):
  • Light bleeding/discharge (brown or pink) for 2–4 weeks.
  • Mild cramping (similar to period pain).
• Rare but serious:
  
  • Heavy bleeding (soaking >1 pad/hour).
  • Infection (fever, foul-smelling discharge, severe pain).
  • Narrowing of the cervix (stenosis – rare, may affect future fertility).
  • Slightly increased risk of preterm labour in future pregnancies.

Recovery and Aftercare

• Immediately after:
  • Rest for 30 minutes; most go home the same day.
  • Use sanitary pads (no tampons) until bleeding stops.
• Self-care:
  • Avoid sex, swimming, or baths for 4–6 weeks (to reduce infection risk).
  • Take paracetamol/ibuprofen for cramps.
• Return to work: Most resume normal activities within 1–2 days.

Follow-up Care

• Results: Discuss lab findings at a 2–4 week follow-up.
• Cervical screening:
  • Repeat smear tests and HPV checks every 6–12 months until normal.
  • Attend routine screening as advised (even after treatment).