This photo series is taken during this 33 year old woman’s colposcopy and LLETZ procedure (Large Loop Excision of the Transformation Zone), also called a LEEP procedure (Loop electro-surgical excision procedure). She has had no vaginal births and you can see her os is round.
Her pap smear came back with abnormal results due to HPV. During the next appointment, the gynocologist applied acetic acid/iodine to her cervix to better highlight abnormal cells (colposcopy), but said the abnormal area appeared mild. However, the tissue sample collected came back as severely abnormal, so she went to the clinic again for the LLETZ procedure (photographed below).
This woman describes the procedure as “a walk in the park.” It was performed with local anesthetic in an outpatient clinic.
This cervical photo is the point of view of the colposcope (projected onto a TV screen) during the beginning of the procedure.
She did not feel the injection of anesthetic at all, but the adrenalin in the mixture made her legs shake and made her feel a little panicky (though this was chemically induced, not her true feeling about the procedure).
This is the photo of the acetic acid and iodine solution applied to the cervix to temporarily stain the cervix and help visualize any abnormal cells in the transformation zone (where many precancerous and cancerous lesions often arise). The whiter area indicates the abnormal cells.
She experienced slight discomfort when the loop excised the tissue. It felt like a short sharp poke but the sensation was gone immediately and she didn’t feel the extra cauterisation. She said the hot wire loop caused a burning smell.
The wire did not stop the bleeding completely, so the colposcopist used another instrument to cauterize the incision (pictured above). If you look closely, you can actually see a small blue flame above the tool on the cervix.
This is the abnormal tissue in a specimen jar. The biopsy showed Cin2 (pre-cancerous) with no clear margins (however as the edge of the tissue was burnt, they couldn’t see the true margins).
Later that night (three or more hours later), she had some slight cramping but no pain after that. She experienced no bleeding until 5 days or so after when the dark cauterized bits of flesh fell off. She bled lightly for a couple of weeks and was given antibiotics for an infection. She was required to refrain from sex, tampons, swimming, heavy lifting, strenuous exercise etc. for a 2 or 4 weeks after the procedure.
She had a follow up pap smear 6 months after the procedure (they give it time to heal completely) which, thankfully, came back normal. During that smear she didn’t get to see her cervix on the monitor, but the nurse said it looked like a smooth mini donut. The hole/os is now larger than it was.
this is awsome!!! How was recovery?
Comment by Erin — January 24, 2010 @ 5:04 pm
I just had the procedure done. It was painful. It has only been 5 days, I am starting to bleed some but think I may be starting my period. I hope to have a normal pap next time I go in. I have had abnormal cells for over 2 years now that’s why they decided to do the procedure.
Comment by Donna — February 1, 2010 @ 4:37 pm
I had a LEEP and my dr. put me under full anesthesia – all the way out. I’d had abnormal cells for a while and didn’t know it because i had no healthcare and didn’t get paps for 5 years. Also didn’t know I had HPV or what that was. No one talked about HPV before the vaccine they’re marketing now. I was completely freaked out and unhappy and I think that’s why she recommended full anesthesia. This was not a cheerful experience. I bled black chunks for 3 weeks. I hope this is never necessary for me again. Now I have to make my new OBGYN (I moved) give me a pap every 6 months. He thinks I’m silly. I think he’s never bled black chunks for 3 weeks and cried.
Comment by Abbie — February 2, 2010 @ 11:04 pm
Ha! Another knock out against cervical cancer! Excellent.
Comment by Lorrie — February 10, 2010 @ 7:01 pm
I am glad there is a website like this to show people what they do and you can actually see everything. I had to get this done 4 years ago and now i once again had an abnormal pap, i get to enjoy this painful procedure again. I am really not looking forward to it, the last time i had 3 biopsies. The dr did tell me i had HPV and they did freeze off the abnormal tissue on my cervix so i was hoping it was gone. Surprise 4 whole years later i have to go through it again. I am sorry for anyone who has to get this done but it is worth it for the drs to find out what is wrong. So good luck to ya ladies!
Comment by Amanda — February 17, 2010 @ 11:21 pm
I am so glad to have stumbled across this site – I am going to share this with others for sure.
I had a LEEP done TODAY! I was initially petrified but once I read up on it I became much more relaxed. Parts of the procedure were painful but it was due to my body composition and not the actual procedure.
I saw the sample after it was removed, I have to say it was larger than I expected but that’s ok…I am hopeful everything necessary to be removed was in fact removed. Now the waiting game for the results.
Your photos here are very informative and I appreciate you sharing them with others.
Comment by Malinda — March 4, 2010 @ 1:13 am
Thanks for posting this. I have HPV. My first biopsy came back mild. My second came back mild/moderate according to the nurse. It’s been a month, and I still can’t get the doctor on the phone to tell me anything more, so I don’t know if they want to do a LEEP or not. But both biopsies were pretty uneventful at least. They just felt like 10-15 minute paps with some period cramping. Not looking forward to a LEEP, but I’m glad we at least have the technology to battle this kind of stuff. I made an HPV/colposcopy article on my website with general information as well as my experiences thus far if anyone wants to check it out, add to it, or make suggestions. http://www.peachdough.com/joomla/index.php/topforum/11-sex-ed-pregnancy-and-parenting/25-reproductive-health-pap-smears-and-hpv.html#105
Comment by Amy — March 4, 2010 @ 7:46 pm
Ive had 2 of these procedures, and ive just received a letter today stating that im having my third next week. Going through this before doesnt make it any easier, but im so glad its being caught before anything more serious happens!
Comment by Jo — March 17, 2010 @ 5:39 pm
I was yesterday told that i needed to have a leep done. I am absolutely petrified to say the least. I’ve read lots of helpfl info on the web, thank god for the net, but i’m still scared.
My gynaecologist is lovely. When I had to have a colposcopy done I was so nervous but he was really gentle with me and understanding so I at least feel at ease with the guy who will be doing it.
I just want to say that for people reading this in the UK.. I had a smear test done on the nhs and it said all clear, see you in 6 months. However a family friend is a doctor in private healthcare and suggested I get one done privately, which was £50, a smal price to pay for health I feel.
I went privately, got it done and got the results back within a few days. It said I had HPV and mild dyscariosis. And that I needed a Colposcopy! Totally different from Nhs result who said come back for another smear test in 6 months time !
I;m so thankful I got a smear test done privately. WHo knows what woulda happened otherwise !
I’m not saying it would happen usually but for me going privately may have saved my life and prevented me getting something more serious..
x
Comment by caro — April 1, 2010 @ 5:16 am
Yesterday i had a colposcopy and might i say i got the run around about the who procedure (no insurance). The doctor who gave me my pap test told me that my results came back abnormal, this had never happend to me before, so naturally i came home and did some research on the internet about all of the possibilities. Little did i know it could be HPV that causes abnormalities or a list of other things. When i arrived at my appointment i asked the assistant “what caused my reading to come back abnormal was it HPV ?”she answered with such confidence “Oh yeah thats probably what it is, thats very common.” At this point im upset because im a 24 year old African-American women with an exceptionally short list (2) of sexual partners and found that her explanation was non-sufficient and further more felt that she(an office assistant) had no place to assume that particular diagnosis and should have had the doctor further explain herself. Well, long story short, she checked the files again and told me it was NOT HPV. So after having the living day lights scared out of me i was escorted to the room where the colposcopy and cervical biopsy was taking place, (still have not found out what abnormality made cause for these test). I had never seen the doctor who was performing this procedure she didnt even explain what was about to happen, i had a good idea of what would happen from my own personal research on the matter. She was not gentle at all and asked me to relax as much as i could. This was difficult! They also had a student watching and taking notes for a grant total of 3 people in my crotch, not a good experience. After the procedure was over the doctor was about to leave when i asked her what caused the pap to come back abnormal and thats when she told me “they found some cancerous cells and needed to further investigate” (hence the colposcopy and biopsy). I was in complete shock, i shut down. Later on last night i decided to do even more research and saw that it could have been ASC-H, LSIS, HSIL…and the list goes on. Now im still in the dark about whats going on. I called and asked to speak with the doctor but of course she was busy and said she would call me back. About an hour later i get a call from the clinic. I start to talk about how i was feeling about what was going on and asking question in which none of them she could answer. Which led me to feeling like i knew more about the situation than she did. I quickly realize that its not the doctor im speaking with but the same misinformed ASSisstant who told me i had HPV when i didnt! Now im still waiting for the call from the doctor….pure hell! Why do some doctors treat their patients like ignorant cadavers to play with, do they not think we are intelligent enough to know or comprehend whats really going on, or do they just not give a damn?! If u have insurance please be thankful u dont have to g through this!
Comment by jessica — April 7, 2010 @ 7:05 pm
Regarding the post from April 7, 2010 by Jessica – That experience was identical to mine in a nut shell. I had my pap test results come back abnormal & had my colposcopy scheduled for this past Monday, April 5th 2010. The office I go to was good about sending me information about the procedure – but I was never given an answer as to why my results came back as abnormal. Very little information was given from them, really. The day of my procedure, I also had two assitants observing – i’m 19 years old, i’m young. So I was extremely freaked out & freaked myself so much – that when my doctor was done, I was extremely dizzy & did not want to stand up. They provided me with juice & made sure I was okay before leaving. Please note I had freaked myself out & hadn’t eaten before my apt, so feeling dizzy had nothing to do with the actual procedure. – the procedure wasn’t *too painful, as she “froze” the cells before collecting them. My results were sent to me (already) in a hand-written envelope telling me that my results were negative for dysplasia. So that’s a relieve -as but that’s all that was noted. I’ll be calling to attempt to get more information on monday, but is it common to get the results back so soon? Also – she told me no intercourse for 2 weeks & told me to expect to see a substance that resembles “coffe grounds” in my panties within the next few days. This was due to whatever was used to stop the bleeding on my cervix. My question to whoever may know, is…
How come today, 6 days after my procedure… while showering, I had something *fall out.. it looked exactly like a little coffe ground filter with orange/brownish substance inside? It had a little weight to it, I might add. & every day since monday – i’ve had some orange stains but was not too conerned.
Hope anyone can help me – as I said, I haven’t had a chance to speak with my doctor since this happened on a sunday =/
Comment by Laura — April 11, 2010 @ 12:36 pm
I am having LLetz surgery done tomorrow, im so scared! But i think my main worry is that i want to have a baby in a few years and im hoping this dont effect my chances of carrying! Wondering if any of you carried a baby after this surgery? Thanks for your time and this site is very help full. I read it and look at the pictures and makes me a little more ensured ill be okay!
Comment by Dianne — April 11, 2010 @ 1:52 pm
Dianne, I had a LEEP done about 7 years ago and I have a healthy 14 month old baby boy. I had no problem getting pregnant, my big fear was carrying the baby to term. The one thing that my doctor did during the pregnancy was a transvaginal ultrasound each month to measure the cervix. It was a relief to have those done and to get to see the baby. Just ask the doctor what the protocal is for a woman that has had the procedure and it pregnant. Goodluck with everything!!
Comment by Natasha — April 13, 2010 @ 11:29 pm
Thanks thats good to hear! I had it done everything is going okay every now and than i have small blood clots and start to bleed heavy for a few minutes than it goes back to normal or just spotting but the dr said that is all normal for 4-6 weeks! My Dr said that the only thing he would be concerned about is me having premature birth but like you said they will monitor that
… Also i had a question i had it done 6 days ago and now i have a bit of brownish blood discharge and smells foul is that normal? Thanks for your time
Dianne!
Comment by Dianne — April 17, 2010 @ 10:22 pm
Hello. I’m the lady is the photos!
Laura, I think your “coffee grounds” will be the cautorised flesh breaking away during healing. I thought mine were kind of like oreo cookies crumbled! Once they fell out I started to bleed. After a few days the bleeding seemed to get heavier and that is when I had an infection. A course of antibiotics sorted it out no problem though.
Dianne, I would say bleeding is normal but mine didn’t smell at all. Maybe check with your doctor as you might have an infection?
Comment by Kathy — April 19, 2010 @ 9:15 am
Hello and thanks for these wonderful photos. I am 29.. had colposcopy done 3 days ago and while the SMEAR result was Mild, nurse colposcopic detected an area of abnormality presumably more than mild and closer to moderate. Then he took biopsy from my cervix and I will be call back for the LEEP once the results of biopsy are out. I was just wondering if I should tell about this whole thing to my future partner especially if everything goes well after the LEEP? I mean I am single at the moment but what about in future…any comments ladies?
thanks a lot
Comment by Mena — May 3, 2010 @ 4:44 pm
I am 27 years old with HPV. I had my first colposcopy and LEEP last year. Prior to that I wasn’t fully aware of HPV or what even caused abnormal paps. I am extremely knowledgeable of my body and sexuality yet I don’t recall being taught about HPV. I had several experiences like most of you women. I had to find answers myself on the internet or ask friends who have gone through this before. After going through this extremely emotional experience I am a huge advocate for getting the information out there. We need to talk about this, every woman should know this information. Our doctors and nurses need to understand what we are going through and not just blow us off. To those of you who are medical practioners and do understand, thank you. I thank you for doing this and just hope that each and every one of you can help someone else with information that can hopefully lead to prevention so less women have to go through what we have, and of course stopping cervical cancer. Again, thank you.
Comment by Emily — May 12, 2010 @ 11:30 pm
I totally agree … the doctors and nurses don’t tell enough and don’t explain what it exactly is! My GP told me that I had the Ward virus (another way of referring to HPV) and the doctor who did my colposcopy said most probable I no longer had the HPV! Then after the biopsy results came out, when I called the nurse, she went on giving me a more comprehensive explanation! And in between each of these, I went through too much stress, hours and hours searching the web to an extent which I even logged to Virology journals by my student account and read medical papers to understand better!(Which of course is even more misleading for a non-medical person) All these could be explained to me in less that 5 minutes by those who were handling my case! Still I am not told directly if I have the HPV! however as I have been receiving a few abnormal SMEARs, I understand at some point they must have tested my sample for HPV and they have the answer already! Thanks to you ladies for sharing your experiences.
Comment by Mena — May 19, 2010 @ 8:01 am
Well, as I understand it, we’ll always carry the HPV virus (its like the coldsore virus), it could be dormant but it can become active at any time. Its when its active that it damages the cells and is contagious.
As for future partners; use condoms. I don’t know if it would kill a fella but it could result in their future partners getting cervical cancer and dying. At least there is a vaccine against some of the HPV strains now.
Comment by Kathy — May 29, 2010 @ 7:33 am
I have had many colposcopies, biopsies & also laser ablation performed with a local anaesthetic (in preference to the LEEP)…the recovery time is minimal – discomfort was nothing when compared to a bad period. I’m part of an international research trial for the vaccines effectiveness in the 26-45 age group & this information interests me a whole lot. Well done wiht the photos!
Comment by Jen — June 17, 2010 @ 3:08 am
I just got the call yesterday that I have to go in to have the LEEP procedure done.I’m 35 yrs old and just last month found out I have HPV, had my 1st abnormal pap, and now moderate dysplasia…good lord! Some things are out of our control but I can say I have quit smoking! My only worries are that my husband and I are currently going to fertility to get pregnant. Maybe this is my body’s way of telling me “hey get me fixed before you get pregnant”!
Comment by Jenn — June 17, 2010 @ 8:29 pm
Wow amazing to see! I had LLETZ surgery about 8-10 years ago. I was terrified, although now I can hardly remember. They wanted to knock me out with a general, but I refused, although they gave me something pretty strong that had me telling the nurse next to me that she was an angel and I loved her! I got an infection after, nothing a little antibiotics couldn’t help. I was very, very distressed by the grey ash discharge! I have only just managed to get a clear reading after all this time, my pap smears kept coming up as ‘possible abnormalities’. I went to an oncologist, who suggested we do a HPV DNA test. I have had this HPV DNA done a number of times and it is negative everytime. From this they concluded I was fine, although the last pap smear was 100% normal! I framed the letter that said I was all clear and should be tested in 2 years! My cervix is apparently spotted with scars from biopsy and the LLETZ. I have a 5 year old, and apart from a little spotting at about 10weeks (no one seemed to think this was related to the LLETZ) had no issues. My understanding is the ‘cone’ drilling can weaken the cervix and may require a stitch to be sewn into the cervix during pregnancy.
Goodluck to any woman who is having it done.
Comment by pinky — June 19, 2010 @ 11:42 am
i have to go for my LLETZ procedure on the 7th of july , i have been for several smear tests and a couple colposcopys with biopsies and my result came back as cin 3 and my smear was severely dyskaryotic, which i have been informed of (as i didnt entirely understand what this meant) by a friend who is a medical student that this means the cells are in the early stages of malignancy
.
I just have a couple of questions really and they are 1) how do they numb the area?is it a needle straight into the cervix or like a epidural sort of anastetic?
2)how long do you usually bleed for? (i dont have periods as i am on the mini pill and that completly stops them so i am a little bit squeamish when it comes to things like that)
3)when is it advised that you can go back to work? as i am a nursery nurse and work with babies so it is inevitable to not be lifting
It would be a great help for any answers to these questions
thank you
xxnicolxx
Comment by nicol — June 30, 2010 @ 2:52 pm
I had a LEEP yesterday and I have to tell you, I would rather go through the LEEP then the biopsi that I had last week. She took a LOT of my cervix out because the biopsi from last week showed Cin III (which is just this side of cancer). My Dr was fantastic and said I could watch it on the sreen if I wanted to (I did not). I could have worked afterwards, if my legs werent’ so shaky. I am at work today. Granted I have a desk job, but I have very little pain at all. Nothing a couple of advil have not helped.
I had an abnormal pap, was told to have the colposcope and they biopsied at that time. That was semi painful. It didn’t hurt as bad as I thought it would, and I am a wimp when it comes to pain. The worst part of the LEEP was the shots and although it was uncomfortable, it was not painful enough that I couldn’t ask questions and talk to the dr. Really my biggest problem was my own nervousness, not the proceedure itself. I am really happy with the way it went
The only suggestion that I would give to the ladies that are having problems with their doctors not giving information would be when you have the dr in the office, BEFORE they do anything to you, ask them questions. It helps, and Bring a friend/partner. they will help you remember what to ask, and will help you remember what the answer is.
My diagnosis was pretty bad, and I am sure that after they have tested what they took out of me yesterday, I will be told that it was full blown cancer. So I am happy that they cut it out. as soon as I have my follow up I will update here.
Comment by happy in cali — July 2, 2010 @ 1:21 pm
i have had my lletz procedure done this afternoon i dont really know why i was worrying so much,i was the last one on the list i was taken down at 11.30 given my general aneasthetic at 11.45 and i woke up at 12.20 and was on my way home before 1.00!i have got some aching the smallest amount of blood literaaly couple of spots so far,iv been advised not2go back2work till mon as lifting may cause the wound2open just wanted 2 say thank u 4 a wonderful site really answered a lot of questions and in a way made me relax a little xx
Comment by nicol — July 7, 2010 @ 3:13 pm
Well I am 1 week after my LEEP and I am still feeling great. I am bumbed because I haven’t been able to work out (i was on a weight loss program. But I have had no pain. I am sexually frustrated and wish I knew if I could give myself an orgasim without pentration) but it didn’t even occur to me to ask my Dr at that time. Other then that things are great
Comment by happy on cali — July 9, 2010 @ 12:01 am
went to the docs yesterday as still gettin pain
he says its possibly the start of an infection boohoo hopefully it wont be!but off work for a week cause of the lifting and stuff involved!
Comment by nicol — July 13, 2010 @ 10:30 am
Thanks so much…I feel so much better. I go for my LEEP procedure on August 18. After coming across this sight I’m no longer worried. I can only imagine that it may feel like the biopsy although at the time of my biopsy I was having a miscarriage and didn’t know it so I was already experiencing cramping just made it a little more intense. I’m just hoping that after the procedure that I will no longer experiece abnormal bleeding.
Comment by Brittany — July 21, 2010 @ 10:49 am
So I went back for my follow up today. The whole thing has gone very well. I have to go back for paps every 3 months from now on. But other then that things are good. She told me that the pathology came back as extreemly high concentration of Cin III cells and that she was glad we took out what we did. I will keep you informed if things change but it all looks good for now
Comment by Happy in cali — July 21, 2010 @ 12:28 pm