Key points

• LLETZ removes abnormal cells before they can develop into cancer.
• I perform it as a day procedure in hospital, under a general anaesthetic.
• The procedure itself is short, usually 10 to 20 minutes.
• You go home the same day. Most people return to work within a day or two.
• Results usually take 1–2 weeks. I will explain them and plan your follow-up.

What is LLETZ?

A thin wire loop, carrying an electrical current, removes the transformation zone in one piece. The heat seals the blood vessels as it cuts, which reduces bleeding. The tissue is sent to the laboratory to confirm the changes and check that the edges (margins) are clear.

Why LLETZ is recommended

• Your biopsy showed high-grade changes (HSIL, CIN 2 or CIN 3).
• Your colposcopy and screening results suggest high-grade changes.
• Changes have been found in the glandular cells. A cone biopsy is sometimes preferred for these.
• Low-grade changes have persisted over time, and we have agreed that treatment is the best option.

LLETZ removes all the abnormal cells for most people. Yearly Test of Cure testing afterwards confirms this.

Preparing for surgery

Before your procedure

• Follow the hospital's fasting instructions.
• Tell me if you take blood thinners, have a bleeding disorder, or are or might be pregnant.
• Arrange an adult to take you home and stay with you overnight.
• If your period is due, the procedure can usually go ahead. Please let the rooms know.

What to bring

• Medicare card and health fund details
• A list of your medicines and any allergies
• Pads (not tampons) for afterwards
• Comfortable, loose clothing

What happens on the day

1. Admission. The rooms will confirm the hospital, your admission time and fasting instructions.
2. Before theatre. I will see you to answer any questions and confirm your consent. The anaesthetist will also speak with you.
3. The procedure. While you are asleep, a speculum is used to see the cervix and the abnormal area is removed with the loop.
4. Recovery. You wake in recovery with a pad in place, and go home after a few hours.
5. The next 24 hours. After a general anaesthetic, do not drive, drink alcohol or sign legal documents for 24 hours.

Risks

• Bleeding. Light bleeding is expected. A heavier bleed can occur around 10 to 14 days later as the area heals. Heavy bleeding that needs treatment is uncommon.
• Infection. Uncommon. Signs include fever, an unpleasant-smelling discharge or increasing pain.
• Incomplete removal. Sometimes not all abnormal cells are removed, and further treatment is needed.
• Narrowing of the cervix. Rare. It can make periods painful or later tests harder.
• Future pregnancy. A slightly higher chance of preterm birth, mainly after larger or repeated treatments.
• Anaesthetic. The anaesthetist will discuss these risks with you.

Common questions

Questions to ask your doctor

• How much tissue are you likely to remove?
• How might this affect a future pregnancy for me?
• When will I get my results, and how?

When to seek help

After LLETZ, please contact me if you have heavy bleeding (soaking a pad in an hour, or large clots), a temperature above 38°C, discharge with an unpleasant smell, or pain not eased by simple pain relief. If bleeding is very heavy or you feel faint, call 000. See also Aftercare following LLETZ.

Who to call

Rooms

03 8400 6193 — appointments and non-urgent questions, business hours

Urgent, after hours

Dr James Aridas, 0459 706 061 — urgent gynaecology concerns, and pregnancy concerns before 20 weeks

From 20 weeks pregnant

The birth suite at your booked hospital: Epworth Freemasons 03 9483 3833 · Cabrini Malvern 03 9508 6000 · Jessie McPherson 03 9594 2776

Emergency

Call 000 or go to your nearest emergency department