A LLETZ is a procedure to remove abnormal (pre-cancerous) cells from your cervix. Treating these cells early helps to prevent them from developing into cervical cancer.

LLETZ stands for “Large Loop Excision of the Transformation Zone.” The Transformation Zone is the area on your cervix where abnormal cells are most likely to develop.

During the procedure, your doctor uses a very thin wire loop with an electrical current to remove abnormal cells.

Most LLETZ procedures are done in a clinic using a local anaesthetic to numb your cervix. Some people choose to have it done under general anaesthetic (you are asleep), this is an option that you can discuss with your doctor.

This is a safe and effective procedure, and you will be taken care of.

You may be offered a LLETZ if your biopsy or cervical screening (smear test) has shown abnormal cells.

Removing these cells through a LLETZ helps to reduce your risk of cervical cancer in the future.

It’s normal to feel nervous, knowing what to expect can help. Here is what to expect during a LLETZ:

• You’ll lie on a clinic bed with your legs elevated in supports (stirrups).

• A speculum is gently placed into your vagina so the doctor can see your cervix.

• The doctor will first take a closer look at your cervix using a colposcope (this is a type of microscope that stays out of your body and doesn’t touch you).

• A small amount of local anaesthetic will be injected into your cervix. This will sting briefly.

• You might feel your heart beating faster briefly because the anaesthetic contains adrenaline, this is totally normal and settles within a minute or two.

• The doctor will check that your cervix is numb and then remove the abnormal cells using the wire loop. This only takes about 10 seconds, and you may feel a warmth or slight sensation (but it should not be painful).

• The doctor then seals the area with the same device to stop any bleeding.
  The speculum is gently removed, and the procedure is finished.

The kaiāwhina can sit with you after your appointment and give you something to eat and drink.

Make sure you have a full puku/have eaten beforehand. If you have chosen to have your LLETZ done under general anaesthetic, you will be given specific fasting instructions.

You may choose to wear comfortable clothing, and a pad or liner in case of light bleeding following the procedure. If you don’t have any pads or liners, kei te pai! Our clinics will provide some for you.

You are welcome to bring a support person with you to your appointment. You may also want someone to drive you home, get in touch if you need help with transport and our team can assist.

We advise you to take things easy for the day.

You may have some period-like cramps, pain relief such as paracetamol or ibuprofen can help.

Light bleeding or discharge is normal and can last 2-3 weeks.

You should avoid heavy exercise for 2-3 days.

For the first few weeks:

• Avoid penetrative sex and putting anything in your vagina for 4 weeks

• Do not use tampons or menstrual cups for 4 weeks

• Avoid baths, swimming, and spa pools for 3-4 weeks

Most people recover from a LLETZ without any problems. However, as with any procedure, there are some risks.

You can get in touch with your doctor/our team at any time if you are concerned about your recovery or have any questions. We are here to help.

Bleeding

• Light bleeding is common for 2-3 weeks

• Occasionally, bleeding can be heavier

• Your first period after a LLETZ may be heavier than usual

Infection

• There is a chance of infection from a LLETZ procedure, the signs of infection include strong-smelling discharge, increased bleeding, fever or feeling unwell

• Infection can be treated with antibiotics, get in touch with your doctor if you have any concerns

Future pregnancy

• There is a small increased chance of early (preterm) birth in future pregnancies

• This depends on how much tissue is removed

• Let your doctor or midwife know you’ve had a LLETZ, they can monitor you more closely if needed

Abnormal cells returning

• Sometimes abnormal cells can come back

• This is why regular cervical screening is important!

You should get your results within 3-4 weeks of your appointment.

Usually, the doctor will write to you and your GP with the results.

It is perfectly normal to be anxious when waiting for results—be assured that you have made the right decision to have a LLETZ procedure, and that prevention is the best cure!

You can still have a LLETZ if you have an IUD. A LLETZ does not affect how your IUD works, as it sits inside your uterus.

• The string may become shorter during this procedure

• This can make removal slightly tricker in the future, but it is still safe and effective.

Your doctor may remove your IUD just before the procedure and insert a new one straight afterwards. Kōrero with your doctor about your options, or if you have any concerns.

Yes, the LLETZ can still go ahead, and the doctor can wipe away any blood on your cervix. If you are bleeding heavily or would prefer to reschedule (or have a kōrero with your doctor first) then please contact us so that we can accommodate your needs.

A pad will be provided if you need one.

A LLETZ procedure is done in clinic with local anaesthetic to numb the cervix. A speculum will be in your vagina for about 10 minutes, and some people find this a bit uncomfortable.

You may feel warmth or a slight sensation, or at most a mild discomfort, pressure, or a dull-period-like cramping during the procedure (10-15 minutes), but it should not be painful (if it is, let your doctor know).

You will feel a sting when the local anaesthetic is injected, this only lasts for a few seconds.

Sometimes, LLETZ is done under general anaesthetic (you are asleep) in an operating theatre. Talk to your doctor if you have any concerns about pain or would like to kōrero about your options.

You can ask the doctor to stop at any time during the procedure.

It is understandable to be anxious about LLETZ. You are welcome to attend your appointment and have a kōrero with the doctor and nurse about your options and what LLETZ involves.

If at the appointment you decide you don’t want to go through with the procedure, wish to reschedule, or choose to have a general anaesthetic, then your wishes will be respected. No procedure will be done without your consent.

Let your doctor or kaiāwhina know if you could be hapu/pregnant, as a LLETZ will not be performed if you are pregnant.

If you are unsure if you are hapu, kei te pai! A pregnancy test can be provided/done if necessary.