A minimally invasive procedure to reduce menstrual bleeding.
Large Loop Excision of the Transformation Zone (LLETZ) is a procedure used to treat abnormal cervical cells, known as cervical intraepithelial neoplasia (CIN), identified during colposcopy following an abnormal cervical screening result.
The procedure removes the area of the cervix containing abnormal cells, allowing the tissue to be examined in full and helping prevent progression to cervical cancer.
Your gynaecologist will assess your cervical screening and colposcopy results to determine whether LLETZ is appropriate for you and explain the recommendation in the context of your individual results.
LLETZ is a procedure used to remove abnormal cells from the transformation zone of the cervix. CIN describes abnormal changes in cervical cells and is graded from CIN1 through to CIN3.
These changes are precancerous rather than cancer itself. LLETZ removes the affected area along with a small margin of surrounding tissue, allowing the tissue to be examined in full.
The procedure is designed to treat abnormal cervical cells and prevent them from progressing to cervical cancer.
LLETZ is generally recommended for CIN2 or CIN3, as these grades are less likely to resolve on their own and have a higher risk of progressing over time.
It may also be recommended for persistent CIN1 or in certain other circumstances identified during your colposcopy assessment.
Your doctor will consider:
Treatment options depend on your specific results and may include monitoring, LLETZ or other treatments such as cold coagulation or laser treatment in selected circumstances.
LLETZ may be considered when abnormal cervical cells have been identified during colposcopy and treatment is recommended to prevent progression.
Your gynaecologist will consider factors such as:
Important: CIN is not cervical cancer. Treatment at this stage is highly effective at preventing cervical cancer from developing, although follow-up screening remains important after treatment.
During LLETZ, your gynaecologist uses a thin wire loop carrying a controlled electrical current to precisely remove the area of abnormal cervical tissue.
The loop removes the affected tissue along with a small margin of surrounding tissue. The procedure is performed under local anaesthetic, which numbs the cervix and helps minimise discomfort.
The removed tissue is then sent to a laboratory for detailed examination to confirm the abnormality and whether it has been completely removed.
Before recommending LLETZ, your gynaecologist will review your cervical screening and colposcopy results to determine whether treatment is appropriate for you.
LLETZ is usually performed in the clinic under local anaesthetic, so fasting or preparation for a general anaesthetic is not usually required.
Your doctor will also discuss:
During the Procedure
You will be positioned as for a routine examination and a speculum will be inserted to allow the cervix to be seen clearly.
Local anaesthetic is injected into the cervix, which may cause a brief stinging sensation followed by numbness. A thin wire loop is then used to remove the abnormal tissue. The procedure typically takes around five to ten minutes.
What Can I Expect After LLETZ?
You can usually go home shortly after the procedure and may generally return to work the same or next day, depending on how you feel.
You may experience:
Watery or blood-stained discharge is common for two to four weeks while the cervix heals. It can occasionally become heavier around two weeks after the procedure as part of the healing process.
You should avoid tampons, swimming and intercourse during the healing period to reduce the risk of infection and support proper healing.
LLETZ may:
LLETZ is highly effective, with success rates generally above 90%, although ongoing HPV infection can occasionally lead to new abnormal cells developing in the future.
Important Considerations
LLETZ is generally a straightforward procedure, but follow-up screening remains important to confirm that treatment has been successful and that HPV has cleared.
There are also potential considerations associated with the procedure, including bleeding, infection and the possibility of abnormal cells persisting or returning. LLETZ can have a small effect on the cervix and may slightly increase the risk of preterm birth in a future pregnancy, particularly if multiple procedures are required. Your individual circumstances and future pregnancy plans will be discussed with you.
