Large Loop Excision of the Transformation Zone - LLETZ

What is LLETZ?

The acronym LLETZ refers to large loop excision of the transformation zone, a treatment modality used in patients with cervical dysplasia. In this procedure an electric current is passed through a thin wire loop electrode to excise or cut the abnormal lesion on the cervix. It is also called as loop electrosurgical excision procedure or LEEP. It is important to note that having abnormal cells on the cervix does not mean that you have cervical cancer but these abnormal cells may become cancerous over the time. Thus their early and complete removal is critical.

How is LLETZ done?

The LLETZ procedure is done in a doctor’s office and requires around 30 minutes. It is scheduled when you are not having your menstrual periods. For the procedure you will be asked to lie on your back with your legs in stirrups. A speculum is inserted into the vagina and a local anaesthesia is given by an injection in the cervix to prevent pain. The electric loop is then advanced through the vagina to the surface of cervix. The electric current is passed through the loop to cut the lesion sufficiently deep and wide to remove all the abnormal cells along with the marginal normal cells. After the procedure either a topical paste is applied to the cervix or electrocautery is used to stop the bleeding. The removed tissue is sent to the lab to confirm the diagnosis.

What to expect after the LLETZ procedure?

You can go home soon after the procedure. You will have pinkish watery discharge from the vagina which may be brownish- black if topical paste is used to stop the bleeding. You may have vaginal bleeding or spotting for one or two weeks after the procedure and also you may experience mild cramps after the procedure.

Two important things that you should take care after the procedure are to prevent infections and promote faster healing of the cervix. To prevent the infection you should not use tampons or douches or take tub bath for few weeks till the cervix heals completely. To promote faster healing of the cervix you should not lift heavy objects and should avoid doing heavy exercise for few weeks after the procedure. You should not have intercourse as long as advised by your doctor.

What are the risks of the LLETZ procedure?

In rare cases it results in narrowing of the cervix resulting in problem in menstruation, difficulty to conceive and also increases the risk of premature births in future pregnancy.

What if I come across any problem during recovery period?

You should seek immediate medical attention if you experience any of the below mentioned conditions:

  • Fever
  • Heavy vaginal bleeding
  • Severe pain
  • Missed period
  • Vaginal discharge with strong odour

Please contact the office on 1300733344, page Dr Mirmilstein on 9387100 or attend the Royal Women’s Hospital Emergency Department if you require urgent attention.

Is follow up necessary after the LLETZ procedure?

It is very important to go for regular pelvic exam and Pap smear after the procedure as recommended by your doctor to make sure that all the abnormal cells have been removed and in case the problem reoccurs it is timely diagnosed and treated again.