LLETZ (Large Loop Excision of the Transformation Zone)
Based on a recent exam of your cervix, your doctor decided the LLETZ procedure is a good option for you. The LLETZ procedure removes the entire abnormal area of your cervix with a hot wire loop. The tissue is then sent to Pathology for diagnosis. Some doctors refer to this procedure as LEEP (Loop electro-surgical excision procedure).
How is LLETZ done?
LLETZ can be done in the office/clinic setting. You will be given medicine to decrease cramping and an injection to the cervix to numb the area to be treated. You will need to remove all metal objects, including jewelry, hairpins, barrettes, bras with metal hooks, etc. The nurse will place a "sticky" rubber pad on your thigh to protect you from possible electrical complications. The nurse will help you into the same position that is used for a Pap smear and a speculum will be inserted into your vagina. The doctor will use the hot wire loop to remove the abnormal area. When this happens, a small amount of smoke and odor may occur. A machine is used to remove the smoke and smell from the air. For additional protection, everyone in the room will wear a surgical mask during the procedure.
The recovery time is short. Most women leave within 10 minutes following the procedure.
Instructions after the LLETZ procedure:
The treated cervix needs time to heal and be protected from trauma and infection. To do this, please follow these instructions: Activity: You may return to work and to your normal activities the day after your treatment. Vaginal Discharge: You may have some vaginal discharge. It may be pink, blood tinged or dark brown/black. You may have spotting or bleeding for 1 to 2 weeks after the treatment. You should call a doctor if your maxi pads last less than one hour. Discomfort/cramping: You may have mild to moderate discomfort similar to menstrual cramps. You may take a pain medicine such as Tylenol (acetaminophen) or Motrin (ibuprofen) as directed to relieve this discomfort. Do not have intercourse, douche or use tampons for 3 weeks. Do not lift greater than 25 pounds for one week ( a basket of wet laundry). You may take a tub bath or shower.
Please call the clinic (319) 356-2294 immediately if any of the following occurs: Fever above 100 degrees or 38 degrees centigrade. Heavy vaginal bleeding - soaking a maxi pad in one hour. Severe abdominal pain that is not relieved by pain medication or period. Missed period.
You will need a repeat Pap smear every 6 months for one year, or possibly a repeat colposcopy in 6 months depending on the results of the pathology report. Your doctor will let you know.
If these are all normal, you will need a PAP smear every 6 months for one year. If these Paps remain normal then yearly Paps are recommended.
Pap smears are not as accurate if you are having your period. If you are bleeding on the day you are scheduled for a Pap smear, please call the clinic to reschedule your appointment.
Why are repeat PAP smears important? There are 3 main reasons why we do repeat PAP smears after treatment of dysplasia:
- To be sure the treatment destroyed the dysplasia
- To be sure the dysplasia has not progressed to cancer
- To be sure the dysplasia has not returned
You may come to the University of Iowa Hospitals and Clinics for your PAP smears. This appointment may be made by calling the scheduling office of the Iowa Women's Health Center at (319) 356-2294. You may also have your PAP smears done with your local health care provider.
Please call the clinic and ask for a Colposcopy nurse:
OB/Gyn Clinic: (319) 356-2294 (8:00 a.m. to 5:00 p.m., Monday through Friday)
On weekends, holidays or after 5:00 p.m., please call the following number and ask for the Gynecology resident on call: University of Iowa Hospitals and Clinics: (319) 356-1616.
Peer Review Status: Internally
Peer Review Date: 2004