Loop Diathermy Excision (LLETZ)
This patient information leaflet aims to give you some information about the loop diathermy treatment and also help to answer any questions that you may have. There will be an opportunity to discuss the treatment with the colposcopist / nurse colposcopist at your appointment. We hope by increasing your understanding of the treatment, we will help you to feel less anxious when you come to clinic.
What is loop diathermy excision (LLETZ)?
Loop diathermy excision is a method of treatment used to remove the abnormal cells on the cervix (neck of the womb). Needing this treatment does not mean that you have cancer. However, it does mean that the cells are showing some abnormal change that, if left, could turn into cancer in the future. This treatment is an effective way of preventing cervical cancer.
This technique uses an electrically heated fine wire loop to remove the abnormal cells from the cervix, while minimising damage to the healthy tissue. The wound is then cauterised, leaving a small burn. It is performed as an outpatient procedure, under local anaesthetic and takes about 10 minutes.
The piece of tissue which has been removed will then be sent to the laboratory to check that all the abnormal cells have been removed.
You may wish to take mild pain relief prior to treatment to help with any potential discomfort. You may experience stinging/discomfort while the local anaesthetic is injected into your cervix. However, this lasts only for a short time until the local anaesthetic takes effect. While the abnormal area is removed you may experience some period cramp-like discomfort.
Please bring a friend or relative with you for support if you wish.
If you are not using contraception, we recommend that you either avoid intercourse or use condoms for seven days before the appointment.
If you have an intrauterine contraceptive device (IUCD) also known as a coil, in most cases the treatment can still be carried out with the coil in place. There is a risk the coil threads may be cut through during the procedure.
If you are on blood thinning medication or have a condition that affects your blood, it is important to tell your colposcopist before your appointment. You may be at higher risk of bleeding after the treatment.
If you are on your period at the time of your treatment appointment, we recommend you contact the Colposcopy team for advice.
Why do I need treatment and what are the benefits of treatment?
Following your recent smear / colposcopy examination, you will have been advised that you need treatment to the abnormal cells of the cervix. By performing this procedure, we will be removing the abnormal cells which have been identified.
This does not mean that you have cancer, but the cells are showing changes that are pre-cancerous and if left could develop to cancer in years to come. The treatment is 90% effective in removing all the abnormal cells. However it is still important to have regular follow up screens as directed to confirm this.
What exactly happens when I come for treatment?
Treatment is very similar to that of a colposcopy examination. You will have a consultation with the colposcopist / nurse colposcopist first, and then you will be taken into the examination room. You will be asked to undress from the waist down (if you wear a skirt, this does not need to be removed). You will be given privacy and time for this.
The colposcopy nurse will ask you to take a seat on the examination couch, providing you with a modesty sheet. The couch has padded supports on it where you rest your legs. The colposcopy nurse will help you position yourself correctly.
When you are in a comfortable position, the colposcopist will gently insert a speculum into the vagina, the same as when you have a screen test. The colposcopist will then use the colposcope to examine the cervix and also dab on the different liquids to help identify and highlight the abnormal areas.
Once this has been done the abnormal areas will be numbed using local anaesthetic. Time will be given for the local anaesthetic to work, and then the treatment will be carried out. The treatment can take around 10-15 minutes in total.
After the treatment the speculum will be removed and you will be asked to stay on the examination couch for a few minutes to rest. The colposcopy nurse will then ask you to get up and dressed in your own time, giving you privacy to do so.
Once you are dressed you will be taken into a recovery room where you will be given a hot drink. The colposcopist will then talk to you about the procedure.
What will I expect to happen afterwards?
You may experience some or none of the following:
- The procedure should not be painful but may cause some mild discomfort similar to period-type pain / cramps. Paracetamol or ibuprofen should relieve any discomfort you may experience after the procedure.
- You may experience a red / brown discharge for a period of time. It could be a few days to four weeks following the treatment. You may also notice a few black particles which are normal, resulting from the diathermy used during the treatment. Everyone heals differently, and some people may experience discharge for longer than others.
- There may be a temporary change in your menstrual cycle after treatment.
You are advised to:
- Rest for the remainder of the day.
- Bath or shower as normal but do not attempt to douche inside the vagina, and avoid using perfumed products.
- Use sanitary pads for four weeks, not tampons; this will help to reduce the risk of infection and allow the cervix to heal.
- Avoid intercourse for four weeks; this will help to reduce the risk of infection and allow the cervix to heal.
- Avoid swimming for two weeks or until the bleeding / discharge has stopped. Other normal activities, including light exercise, may continue.
Other things to consider:
- You may drive following treatment, unless advised not to by the colposcopist.
- You may consume alcohol in moderation after treatment.
- Due to the risk of post treatment infection, it is advised that treatment must be postponed until you return from holidays overseas. Please note if you seek medical attention outside of the UK for the complications arising from the treatment, this may not be covered by your insurance.
How will I know if something is wrong?
Occasionally infection may develop in the healing skin which might cause heavy bleeding around 10-14 days following treatment. If you have any heavy bleeding that is worse than a normal period or you are at all concerned, contact your GP or ring the clinic for advice.
If you experience any on-going period-like cramps, smelly discharge, a fever / raised temperature, you may have an infection, please contact your GP or ring the clinic for advice.
What should I do if I have a problem?
If you have any concerns following your treatment please don’t hesitate to contact the Colposcopy Clinic Team, (contact details are at the end of this leaflet). We do also advise you to contact your GP.
Out of clinic and surgery hours, we advise you to contact:
Ward 16 at Royal Lancaster Infirmary: telephone 01524 583820
Ward 1 at Furness General Hospital: telephone 01229 870870 (internal extension: 54107)
What happens to the abnormal tissue that has been removed?
It will be sent to the laboratory for analysis. The laboratory checks that all the abnormal cells have been removed and will confirm the grade of abnormality.
Risks of treatment
Pregnancy
The procedure has no effect on fertility (the ability to conceive).
Loop diathermy excision has been shown to be associated with a small increase in the chance of preterm labour and preterm pre-labour rupture of membranes. This is a small risk which is outweighed by the benefits of removing the abnormal cells from the cervix which, if left untreated, may develop into cervical cancer in the future.
Labour and Delivery
Very rarely, cervical stenosis (tightness of the neck of the womb) occurs after treatment, with the risk of the cervix failing to open during labour. In these cases a caesarean birth is performed. The risk is very small, approximately 1%.
IUS / Mirena or IUCD / Coil
Often the colposcopist can perform the LLETZ procedure whilst the coil is still in position. This is done by pushing the coil threads up out of the way. However, we do advise that if you do have a coil that you avoid sexual intercourse or use barrier contraception (condoms) for seven days before your treatment just in case the coil needs to be removed.
When will my results be available?
In approximately four weeks. We will write to you and your GP with the results.
Will I need to come back to the colposcopy clinic?
Depending on the results, you will either be seen back in the clinic or discharged back to your GP.
In most cases, you will be asked to see your GP in six months’ time for a HPV (Human Papilloma Virus) test (known as ‘TEST OF CURE’).
It is very important that you attend for your cervical screen following treatment.
The Colposcopy Clinic Team would be more than happy to answer any questions / queries you may have.
Please contact the numbers below and ask to speak to a member of the Colposcopy Clinic team:
Colposcopy Clinic Team at Royal Lancaster Infirmary and Westmorland General: telephone 01524 512338
Colposcopy Clinic Team at Furness General Hospital: telephone 01229 403616
(Monday – Friday 8:30am-4:30pm)
Out of clinic and surgery hours we advise you to contact:
Ward 16 Gynaecology at Royal Lancaster Infirmary: telephone 01524 583820
Ward 1 Gynaecology at Furness General Hospital: telephone 01229 870870 (internal extension 54107)
Useful Websites
British Society for Colposcopy and Cervical Pathology - www.bsccp.org
Healthtalkonline -www.healthtalkonline.org
The NHS website - www.nhs.uk
Cancer Research UK – www.cruk.org
Cancer Screening NHS - www.cancerscreening.nhs.uk
Date of publication: 01/10/2016
Reference code: PIL055
Review date: 01/07/2026