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LLETZ Procedure

Large Loop Excision of the Transformation Zone (LLETZ Procedure)


What is the LLETZ procedure?

The LLETZ procedure is a method used to treat the cervix of a woman who has had an abnormal pap smear and risks developing cancer of the cervix.  This surgery gently removes a small segment of the cervix (the transformation zone) and is performed to diagnose and treat pre-cancerous cells.

A fine wire loop charged with electricity is used to shave away abnormal tissue from the cervix.  This tissue is then sent to pathology to confirm diagnosis.


How are these cell changes recognized?

Generally, women are unaware that they have pre-cancerous cell changes of the cervix.  These changes do not cause bleeding, pain or discharge.

The only way for these cells to be detected is by having a pap smear.


What are the risks of this procedure?

Although the risks of the LLETZ procedure are very low, you should be aware of the risks, which include:

  • Excessive bleeding from the cervix.  This can require a blood transfusion or further surgery, either initially or within weeks of the procedure.
  • Future pregnancies (usually at around 20 weeks) may suffer from a weakness of the cervix to support a growing pregnancy.  This is uncommon.
  • Infection may be introduced to the cervix, uterus, fallopian tubes or abdomen.  This may require treatment with antibiotics.
  • Damage and narrowing of the cervix could occur, which can cause painful periods and/or difficulty in labour.
  • Increased risk in obese people of wound infection, chest infection, heart and lung complications and thrombosis.
  • Increased risk in smokers of wound and chest infections, heart and lung complications and thrombosis.


After having a LLETZ procedure:

You should be able to leave the hospital on the same day as your procedure.  You should expect to see some blood stained discharge for several days after the procedure, this should settle within 1-2 weeks.  You may experience a clear discharge for up to 6 weeks.

Most patients feel well enough to return to work the following day, but this depends on the individual.

After having a LLETZ, remember to:

  • Eat and drink normally
  • Remain mobile
  • Use pads, not tampons
  • Shower normally, do not bath or swim until you have healed completely
  • Do not have sexual intercourse for 4 weeks
  • Contact your Gynaecologist if you experience severe pain, fever, offensive discharge or heavy bleeding.