LLETZ is a treatment for abnormal cervical cells that have been picked up through cervical screening.

LLETZ stands for large loop excision of the transformation zone. It’s also known as loop electrosurgical excision (LEEP) or loop diathermy. This is the most common treatment for abnormal cervical cells.

Your colposcopist uses a thin wire loop to remove the transformation zone of the cervix. The wire has an electrical current running through it, which cuts the tissue and seals the wound at the same time.

The transformation zone is the area around the opening of the cervix.

Diagram showing the transformation zone on the cervix

LLETZ is an outpatient treatment and takes up to 15 minutes. You usually have it under local anaesthetic.

What happens

At the colposcopy clinic, your nurse asks you to undress from the waist down and then to lie on your back on the examination couch. They give you a sheet to cover yourself. Your legs are supported by 2 leg rests.

Your colposcopist gently puts a medical instrument called a speculum into your vagina to hold it open (like when you have a cervical screening test). They look through the colposcope to examine your cervix.

They inject some local anaesthetic into your cervix. This might sting for a short time. The local anaesthetic numbs the area. Your colposcopist can then remove the area of tissue with the abnormal cells. This is not painful but you may feel some pressure.

Your colposcopist then removes the speculum and you can get dressed when you’re ready.

You should bring a sanitary towel with you to the hospital. You'll need one after the treatment as there might be some bleeding.

After treatment

You might have bleeding and discharge for about 4 weeks after having a LLETZ. You shouldn't use tampons or have sex during this time to reduce your risk of infection.

See your GP or contact your colposcopy nurse if you have:

  • bleeding that is heavier than a period or you’re still bleeding after 4 weeks
  • discharge that smells unpleasant

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