LLETZ or loop diathermy

An area of abnormal cells has been found on your cervix (entrance of your uterus/womb). LLETZ stands for large loop excision of the transformation zone, and is also called loop diathermy. It is a treatment to remove cell changes (abnormal cells) in your cervix and allows us to look at these cells more closely.

First, you will have a colposcopy (test o look at your cervix) to identify the abnormal area.

The colposcopist will inject a local anaesthetic into your cervix. This means you are awake, but the area that needs treating is numb (you cannot feel it). The injection might sting for a short time and you may be aware of your heart beating faster. This feeling does not last for long.

A diathermy plate (big sticky pad) is placed on your thigh (or appropriate area) to make sure the electric current we use does not burn you. The diathermy plate does not hurt and is removed once the treatment is finished.

The abnormal cells are removed using a wire loop heated by an electric current. You should not feel any pain, but you may feel some pressure and experience a dull cramp in your lower abdomen (tummy) similar to period pain.

It is normal to notice a slight burning smell and hear a noise like a soft vacuum cleaner.

Whilst the treatment itself takes just a few minutes, afterwards you will be taken to recovery to rest for 20 minutes, so please allow an hour in total for your appointment.

You are welcome to have someone with you for support.

LLETZ is a simple and safe technique which is successful in over 9 in 10 cases, meaning no further treatment is needed.

Bleeding: There is a small risk of heavy bleeding (for example soaking through a sanitary pad every hour).

Infection: Between about 1 and 14 in every 100 people get an infection after LLETZ. Contact your GP if your vaginal discharge smells bad, or is a yellow or green colour, you have painful cramps or a high temperature (38 degreed Celsius or higher). If there is a chance you have an infection, you will be offered antibiotics.

Cervical stenosis: There is a very small risk that the opening of your cervix will become narrowed due to scarring. This can cause painful periods, difficulty conceiving or cause your cervix not to dilate (open) well during labour. This risk increases if you have been through menopause or have had a LLETZ previously.

Premature birth: There is a small increased risk of late miscarriage or early delivery in future pregnancies.

Burn: There is a very small risk of a burn to your vagina.

You may experience some or none of the following:

• Pain for at least 2 days. This can last up to 4 weeks after treatment. The pain varies from person to person, but should not be severe. It is often described as a cramping pain, like a period.
• Some bleeding and discharge. After the procedure, the bleeding may be like a heavy period turning eventually into a pink or brownish discharge. This could last up to 4 weeks.
• You may feel light headed or faint after your treatment. If you have a tendency to faint, then we advise you to arrange for a friend or relative to accompany you home afterwards.
• If you have periods, your next period may be slightly heavier, lighter or out-of-sync with your regular cycle.

If you are concerned that you are bleeding too heavily or have an infection, please contact Greenoaks or your GP during weekday working hours, or Ward B11 at any time on 01709 424349.

Until all bleeding or discoloured discharge has stopped it is recommended to avoid:

• penetrative vaginal sex - including fingers, tongues and other objects
• tampons or menstrual cups - you can use pads instead
• heavy exercise that causes you to sweat
• swimming and hot tubs
• baths - you can shower as normal

• Please make sure you eat and drink something before your appointment.
• You will be safe to drive following LLETZ, unless advised otherwise by the colposcopist.
• Rest for the remainder of the day following your treatment.
• If you have a contraceptive coil, it may be left in place, but the coil threads may be accidentally cut. This will not affect its use. Your colposcopist will explain on the day.
• Please let your colposcopist know if you have any upcoming holidays, as it may affect your care plan. We may need to delay LLETZ until after your return home, because of the risk of bleeding and infection. In addition, some travel insurance companies may not provide you with cover immediately following LLETZ.
• If you are pregnant then we prefer not to do any treatment on your cervix. We will re-arrange a date, usually 3 months after your baby is born. However, we may suggest a colposcopy during your pregnancy which is not harmful to your baby.
• If you are having your period we can still carry out LLETZ provided that your bleeding is light. Please call the Colposcopy Office or Greenoaks for advice.

Any tissue removed from your cervix will be sent away for testing and we aim to write to you within 8 weeks with your results. Please ensure we have your correct contact details.

We usually recommend a cervical screening (smear) test called a Test of Cure. We offer this 6 months after you have had LLETZ. Occasionally we might recommend further treatment.

Appointments

Colposcopy Secretaries 
Telephone 01709 424300
Monday to Friday, 9am to 4pm

Health advice 

Greenoaks
Telephone 01709 427641
Monday to Friday, 9am to 4pm

Further information

Public information from the British Society for Colposcopy and Cervical Pathology (BSCCP)