Cervical Screening

Loop diathermy (LLETZ)

Loop diathermy, also referred to as LLETZ (Large Loop Excision of the Transformation Zone) is the most common treatment method used if the results of a cervical screening test (smear test) or colposcopy show moderate or severe cell changes (also known as LEEP outside the UK – Loop Electro-Excision Procedure). The abnormal cells are removed using a small loop wire which is heated electrically. The loop seals the area as it goes and the treated areas usually heal within a few weeks. Most women have this treatment at a hospital outpatient clinic and a local anaesthetic is used to numb the cervix. The treatment is quick and women will be able to go home afterwards. In some cases, where a large area of tissue needs to be removed or if women are very anxious, treatment is performed under general anaesthetic as a day patient.

We talked to women about their experiences of LLETZ. Some of the women we talked to were given this treatment at the same time as their colposcopy examination. Others had their treatment at a separate outpatient appointment. A few were admitted at a later date as a day patient.

Although some women felt anxious about the clinical environment of the colposcopy examination many said they found it comforting to have the nurse holding their hand and talking to them during treatment. Others describe ways in which the atmosphere in the clinic helped them to feel comfortable and how they did not find the environment distressing, particularly if they had undergone childbirth or had previous treatments. A few were accompanied by a relative in the treatment room to provide moral support.

Most women found the local anaesthetic injection uncomfortable but not painful. A few women did not feel any discomfort.

During treatment, a few said they felt some discomfort. Several felt embarrassed and found the procedure undignified. Some found it useful to wear a skirt or a long top which enabled them to remove their undergarments but not feel exposed. Despite these feelings, most women commented that their experiences were not as bad as they had expected and they felt they were minor in comparison to the consequences of not undergoing treatment.

Immediately after treatment women can have some bleeding, which should not be heavy.

Some advised wearing suitable pants to the appointment because they would need to use sanitary towels rather than tampons for a short while. After treatment, several women said they felt some discomfort, like a low down period pain, others did not have any discomfort. One woman said she was in pain the next day and experienced heavy periods and painful cramps afterwards. Another went back to work immediately after her treatment and she said she felt fine.

A few who had their treatment as a day patient said that the light general anaesthetic which they had been given did not make them feel ill afterwards.

Women are advised to avoid certain activities after their treatment, such as swimming, sexual intercourse or heavy lifting. Most women found that after an initial abstinence they were well enough to resume these activities.

See more experiences of LLETZ.

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Last reviewed October 2015.

Last updated October 2015.


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