LLETZ Procedure for Severe Dyskaryosis
What is a LLETZ Procedure?
If on a cervical screening test (HPV/smear test) or colposcopy you have been diagnosed as having high grade precancerous cervical cells (moderate/severe dyskaryosis/CIN2/CIN3) which require treatment, you will typically be referred for a LLETZ procedure to manage cell changes after further tests.
LLETZ (Large Loop Excision of The Transformation Zone) also referred to as loop diathermy, LEEP, loop excision, or loop biopsy, is the most common treatment option for those with high-grade precancerous cells of the cervix. The abnormal cells are removed using a heated wire loop and drastically reducing the likelihood of cervical cancer.
What does the Procedure involve?
LLETZ treatment is a straightforward outpatient procedure, typically only taking 10-15 minutes. After numbing the cervix with a local anaesthetic injection, a thin heated wire loop with a mild electric current (known as diathermy) is used to remove the abnormal cells, while also aiming to preserve as much of the healthy cervix as possible and avoid cell changes.
Having the treatment
On occasion, the removal of abnormal cervical cells can be carried out immediately after the private colposcopy examination. Our consultants would carry out the treatment if it is extremely clear that some of the cell changes in the cervix are abnormal and require imminent removal. In other instances, it will not be possible to carry out procedures on cervical pathology on the same day as your private colposcopy London appointment.
This may be because we need to wait for biopsy results in order to determine whether abnormal cells need to be removed with the thin wire loop method or not. Our consultants will guide you on the next steps during your consultation. Our health professionals will ensure that you are well informed during the loop excision of the transformation zone (LLETZ) so there will be no surprises.
Is It painful?
Although LLETZ sounds scary, patients typically only feel slight discomfort during the procedure and have little physical or emotional effects afterwards. As local anaesthetic is used, patients will not be able to feel the removal of the cells from the cervix via the heated wire. The fine needle is placed to numb the area; patients will be able to feel the movement of the speculum.
Although pain varies, after the procedure, patients may experience slight pain, but this will quickly subside and can be eased with regular painkillers. There are rarely ever any lasting physical effects from this procedure.
If you find vaginal examinations very uncomfortable (including colposcopy), then the procedure should be performed under general anaesthetic as a day case.
What happens after the LLETZ procedure?
As LLETZ is usually an outpatient procedure to reduce to likelihood of cervical cancer, patients can go home right away and can immediately resume normal activities. We advise that patients take the day off when having treatment but should be able to return to work the next day. Some discomfort and minor vaginal bleeding are common after the procedure, but this can be alleviated with over-the-counter painkillers and a hot water bottle.
Short-term side effects
Brown Vaginal discharge and blood spotting are normal for the first week after the procedure. For the next 4 weeks we advise patients to avoid the following activities:
- Wearing tampons or menstrual cups. It is recommended that you use sanitary towels instead
- Having penetrative vaginal sex for four weeks, as this increases the risk of infection around the area of cell changes
- Heavy exercising, including swimming, for at least two weeks or while bleeding or discharge is still present. Light exercising, such as brisk walking, is fine.
The first period after treatment may arrive earlier or be slightly heavier than your regular period, but this should settle.
Six months after your LLETZ procedure, you will be asked to undergo another cervical screening and or smear test. This will be carried out to check that there are no abnormal cells or infection with a high risk type of the Human Papilloma Virus (HPV).
Will abnormal cells be gone after the LLETZ procedure?
There is a strong chance that the possibility of cervical cancer will dramatically fall following the treatment to remove abnormal cells. However, a very small number of patients may need to undergo further treatment for unexpected cell change, and this will be determined six months after the procedure, where you will be invited to undergo another cervical screening for potential cervical cancer cells.
In future, it is vital to continue undergoing your cervical screening as advised, because abnormal cells can be detected at any time.
Are There Risks Associated With LLETZ?
The potential risks associated with this type of treatment for cervical cell changes are very low, but there are some side effects that you should be aware of. These include:
- Mild cervical or pelvic pain, which can be similar to period pain and typically passes within a few hours of treatment.
- Bleeding from the cervix and transformation zone lletz, which may require further surgery
- An infection which may require treatment with antibiotics from your doctor or nurse
- Slightly increased risk of premature birth in any future pregnancy
- Inconsistent period fatigue
- If after the procedure you feel unwell, develop a foul-smelling discharge, or notice significant pain or bleeding that is much heavier than your normal period, you should contact your GP immediately, as this can indicate an infection or a condition called cervical stenosis.
Does LLETZ affect fertility or cause pregnancy problems?
No, it does not. The treatment aims to remove the abnormal cells from the cervix that could lead to cervical cancer but preserve as much of the healthy cervix as possible to support future pregnancies. It is extremely unlikely that a woman who has had LLETZ treatment for abnormal cells will experience fertility issues.
Following this treatment, there is a small increased risk of premature birth, before 37 weeks. This risk is dependent on medical history, the amount of cervical tissue that was removed during treatment and whether you have had more than one treatment.
If you are pregnant or are thinking of getting pregnant in the future, it is important to let your GP know that you have had treatment for abnormal cervical cells in order to be referred to a consultant’s antenatal clinic so you can receive the right gynaecological and obstetric care.
Are There Risks Associated With our London LLETZ Procedure?
Our dedicated team of professionals who carry out our dyskaryosis treatment are highly skilled and knowledgeable in cervical cancer. Whilst the physical or emotional risks associated with this cell change procedure are very low, there are some side effects that you should be aware of. These include:
- Mild pain, which can be similar to period pain and typically passes within a few hours of treatment
- Bleeding from the cervix, which may require further surgery
- Infection which may require treatment through antibiotics
- Increased risk during a future pregnancy.
- Unusual vaginal discharge
Before your appointment
Before your appointment, It’s crucial to mention any blood-thinning medication or over the counter medication that could impact your blood. After the procedure, your risk of bleeding can be increased.
If you have been referred for this treatment for cervical cell changes, contact us today to book a consultation with one of our experienced London gynaecologists.