Arge loop excision

Large loop excision of the transformation zone

Your colposcopy has revealed an abnormality on your cervix (neck of the womb) which may be a precancerous change and Dr. Ganu has recommended that this abnormal area be removed by as LLETZ procedure (large loop excision of the transformation zone).

A LLETZ procedure removes the abnormal area of your cervix with a hot wire loop. The tissue removed is sent to

pathology for diagnosis and confirmation that all the abnormal area has been removed. The LLETZ procedure cures about 95% of women with abnormal cervical cells.

How is LLETZ done?

LLETZ is usually done in Hospital in an operating theatre under a general anaesthetic as a day surgery patient. To perform the procedure, you will be asked to lie on an examination couch with your feet supported. A speculum will be inserted into your vagina to expose your cervix in the same manner as at your colposcopy. Once your cervix has been examined some local anaesthetic will be injected into your cervix. When the local anaesthetic has worked, the abnormal part of your cervix will be removed using the hot wire loop. The entire LLETZ procedure generally takes less than 15 minutes.

About 1% of women treated by LLETZ will experience bleeding severe enough to require admission to hospital overnight. This risk is no higher than with the other procedures used in the past to treat abnormal cervical cells.

Potential complications of LLETZ

Potential complications of LLETZ include discomfort, infection, bleeding, superficial burns to the vagina, and cervical stenosis (narrowing of the cervical opening).

About 1% of patients develop cervical stenosis.

It is usually possible for your gynaecologist to dilate or open the cervix later if this problem occurs. Current research suggests that there are probably no increased risks of problems with future fertility or pregnancies.

Instructions after the LLETZ procedure

Your treated cervix needs time to heal and to be protected from trauma and infection. To do this, please follow these instructions:

Activity: It is advisable to have someone accompany you to the procedure and drive you home. You may return to work and to your normal activities the day after your procedure.

Vaginal discharge: You will have a vaginal discharge. It may be pink, blood-tinged or dark brown / black. You may have spotting or bleeding for up to 2 weeks after the procedure.

Discomfort / cramping: You may have mild to moderate discomfort similar to menstrual cramps. Paracetamol or an anti-inflammatory as directed should be adequate. Abstain from sexual intercourse for 2 weeks.

Please contact Dr. Ganu’s rooms on 8299 0302 if any of the following occurs:
Fever, heavy vaginal bleeding (soaking one pad an hour) or severe abdominal pain.

Post Op Appointments.

As no treatment is 100% effective, it is very important to have follow-up after your LLETZ procedure. You will need a repeat colposcopy 6 months after the LLETZ procedure, and an appointment will be made for this at your post op appointment.

You will also need regular PAP smears for the rest of your life.