LLETZ Procedure for Severe Dyskaryosis – What You Need to Know
Introduction
If you’ve recently been diagnosed with high-grade precancerous cervical cells, often referred to as moderate or severe dyskaryosis (CIN2/CIN3), your healthcare provider may recommend a LLETZ procedure. Understanding what this procedure entails, how it works, and what to expect can help ease any concerns and prepare you for the treatment. This post will cover everything you need to know about the LLETZ procedure and why it’s a crucial step in managing abnormal cervical cells.
What is a LLETZ Procedure?
LLETZ, which stands for Large Loop Excision of the Transformation Zone, is a common and effective treatment for removing high-grade precancerous cells from the cervix. The procedure is also known by other names, including loop diathermy, LEEP (Loop Electrosurgical Excision Procedure), loop excision, or loop biopsy. This outpatient treatment involves using a thin, heated wire loop to excise abnormal cells from the cervix, significantly reducing the risk of cervical cancer.
What Does the Procedure Involve?
The LLETZ treatment is a straightforward outpatient procedure that typically takes only 10 to 15 minutes. The process begins with numbing the cervix using a local anaesthetic injection. Then, a thin wire loop, heated with a mild electric current (diathermy), is used to remove the abnormal cells. The goal is to excise the cells while preserving as much of the healthy cervical tissue as possible.
When is the LLETZ Procedure Performed?
In some cases, the LLETZ procedure can be performed immediately following a colposcopy examination if the consultant determines that the abnormal cells need to be removed urgently. However, if a biopsy is required to confirm the presence of abnormal cells, the procedure may be scheduled for a later date. Our experienced consultants will guide you through the process and ensure you are fully informed about the next steps.
Is the LLETZ Procedure Painful?
The LLETZ procedure is designed to be as comfortable as possible. Thanks to the local anaesthetic, most patients only experience slight discomfort during the treatment. After the procedure, some mild pain may occur, similar to period pain, but this usually subsides quickly and can be managed with over-the-counter painkillers. For those who find vaginal examinations particularly uncomfortable, the procedure can be performed under general anaesthetic as a day case.
What Happens After the LLETZ Procedure?
After the LLETZ procedure, most patients can return home the same day and resume normal activities. However, it’s advisable to take the rest of the day off to recover. Minor vaginal bleeding and discomfort are common but can be managed with pain relief and rest.
Short-Term Side Effects
In the first week following the procedure, it’s normal to experience some brown vaginal discharge and spotting. To ensure proper healing, we recommend avoiding certain activities for up to four weeks:
- Using tampons or menstrual cups: Opt for sanitary towels instead.
- Having penetrative vaginal sex: Avoid for four weeks to reduce the risk of infection.
- Heavy exercising: Including swimming, should be avoided for at least two weeks or while bleeding/discharge is present.
Your first period after the procedure may arrive earlier and be slightly heavier than usual but should return to normal in subsequent cycles.
Follow-Up Care
Six months after your LLETZ procedure, you will need to undergo a follow-up cervical screening or smear test. This is crucial to ensure that all abnormal cells have been removed and to check for any signs of infection with high-risk Human Papilloma Virus (HPV) strains.
Will Abnormal Cells Be Gone After the LLETZ Procedure?
While the LLETZ procedure significantly reduces the likelihood of cervical cancer, there is a small chance that some abnormal cells may persist. This will be determined during your follow-up screening. It’s important to continue regular cervical screenings as advised by your healthcare provider.
Are There Risks Associated with LLETZ?
The risks associated with LLETZ are minimal, but it’s important to be aware of potential side effects:
- Mild cervical or pelvic pain: Similar to period pain, usually subsides within a few hours.
- Bleeding from the cervix: In rare cases, further surgery may be needed.
- Infection: May require antibiotics.
- Slightly increased risk of premature birth: In future pregnancies.
- Inconsistent periods and fatigue: Occasionally reported by patients.
If you experience unusual symptoms such as foul-smelling discharge, significant pain, or heavy bleeding after the procedure, contact your GP immediately as these could indicate an infection or other complications.
Does LLETZ Affect Fertility or Pregnancy?
LLETZ is designed to remove abnormal cells while preserving as much healthy cervical tissue as possible. It does not typically affect fertility. However, there is a slightly increased risk of premature birth in future pregnancies, particularly if you’ve had multiple treatments. If you are pregnant or planning to become pregnant, inform your GP so you can be referred for appropriate care.
Before Your Appointment
Before your LLETZ procedure, it’s important to inform your consultant about any blood-thinning medications or other medications you are taking, as these could increase the risk of bleeding during the procedure.
Conclusion
The LLETZ procedure is a safe and effective treatment for managing high-grade precancerous cervical cells, significantly reducing the risk of cervical cancer. With minimal discomfort and a quick recovery time, it’s a crucial step in maintaining your cervical health. If you’ve been referred for this treatment, contact us today to book a consultation with one of our experienced London gynaecologists.