Loop Excision of the Cervix (LLETZ or LEEP)

Loop excision removes abnormal cells from the cervix with a thin heated wire so they can be examined and treated.

Loop excision, also called LLETZ or LEEP, removes a small area of abnormal cervical tissue using a thin electrically heated wire. A clinician usually works through a speculum while viewing the cervix with a colposcope. The removed tissue is sent for laboratory examination, which confirms the cell changes and whether the edges of the sample are clear.

Mild cramping and watery, brown, or lightly bloody discharge can occur after the procedure. Use sanitary pads while the cervix heals, and follow the clinic’s instructions about avoiding tampons, vaginal sex, and swimming. Arrange help if sedation was used. Contact your care team promptly for heavy bleeding, fever, worsening pain, or discharge with an unpleasant smell.

Bleeding, infection, and discomfort are recognised complications. Bleeding can happen immediately or when the healing surface separates later. Rarely, a deeper or repeated excision can affect the cervix in a future pregnancy, including a possible link with cervical insufficiency. Your clinician can explain how the depth and amount of tissue planned affect your individual risk.

The treatment removes the area of cervical dysplasia that was identified, but it does not prevent every future cell change. Follow-up testing checks whether abnormal cells have returned or remain. The laboratory result guides the next appointment and may show that further surveillance or treatment is needed.

The procedure is commonly performed as an outpatient treatment with local anaesthetic. Tell the team if you may be pregnant, take medicines that affect bleeding, or have an allergy to local anaesthetic. Bring any questions about the pathology result and the timing of follow-up.

It may be offered when colposcopy and cervical samples show cell changes that need removal or a clearer diagnosis. The decision depends on the grade and location of the abnormal area, previous results, pregnancy plans, and whether the entire area can be treated safely.

You change in private and lie on an examination couch. The clinician inserts a speculum, applies solutions that highlight the area, numbs the cervix, and removes the tissue with the loop. Bleeding is controlled, and the sample is labelled for laboratory review. The appointment includes time to discuss aftercare before you leave.

Plan a quieter day after treatment. Discharge may continue for several weeks as the cervix heals, while cramps usually settle sooner. Wait for the clinician’s clearance before resuming activities that place anything in the vagina. Attend the scheduled result review even if symptoms have settled.

Seek urgent medical advice for bleeding that rapidly soaks pads, severe or increasing pelvic pain, faintness, fever, or feeling acutely unwell. Ask before taking medicines if you use anticoagulants or have a bleeding disorder.

Depending on the findings, options can include monitoring with repeat colposcopy, a diagnostic colposcopy, or cone biopsy when a larger or deeper sample is needed. The right choice depends on the examination and laboratory findings.

Choose a gynaecology service that can perform colposcopy, provide cervical treatment, and arrange laboratory follow-up. Ask who will give you the result, when it will arrive, and whom to call if bleeding or pain increases.