Colposcopy and LLETZ/LEEP

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 gynecologist 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.

Click here for information about holistically healing cervical dysplasia and HPV.

222 thoughts on “Colposcopy and LLETZ/LEEP

  1. I had the loop treatment 1 week ago after 2 years of monitoring my abnormal cells (cin1/2). The procedure itself was mildly uncomfortable but I was scared which didn’t help. I have only just started bleeding slightly now and have been put on antibiotics for an infection. Not the nicest experience but definitely the right decision, health has to come first! Keeping my fingers crossed for a normal smear test in 6 months.

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  2. I had LLETZ surgery 3 weeks ago for CIN III. I was very lucky to have a surgeon who gave me a general anaesthetic, and also a local so I did not feel a thing. The did 5 sweeps and I felt fine after. A bit of cramping but took some paracetamol and was as good as gold.
    I was told not to work out or have sex, or use tampons for three weeks and I have been following that. I had my surgery done right at the beginning of the period, but took hormone pills to slow it down. They worked a treat and the surgeon said it was fine to proceed.
    They used the brown vinegar solution to see the abnormal cells as the other readers have posted, so the next few days there was a bit of discharge of that, and then the following week broken bits of debris is all I can call it … like a scab falling away, but in small pieces, and then nothing. So I have been absolutely fine.
    The lady that reported a horrific experience – wow, that was really really unfortunate and I felt bad for you when I read that. My experience was very good. I was put to sleep and when I woke up I really wasn’t in any pain at all.
    All the best to those that are about to undergo surgery. I hope it is as pain free and stress free as mine was.

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  3. I had a Colposcopy done when I just turned 18 due to abnormal paps and though it WAS a bit uncomfortable… I mean, even a pap is uncomfortable! lol The the only thing that made me feel any real discomfort was the biopsy. (I assume that’s what it would be called) and it was over fast! Luckily, it was nothing and I just had to have pap smears every 3 months for a year and everything was still fine. I am glad that it was done. It put my mind at ease.

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    Jamie Reply:

    … I forgot to say that afterward for about a day and a half I had a discharge but it was gone as soon as it came. I had a slight irritation immediately following but that’s to be expected when you have someone in you “no no” areas! haha

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  4. I had a LETTZ last wednsday for cin2 and now i am feeling as though im leaking when i cough or even just standing/sitting. Its not thick discharge but rather watery. Is that normal or should i go to a doctor. Im 21 i have 1 child, i wouldnt expect myself to be weak around that area at this age.

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    Becky Reply:

    I have read that there can be a ‘watery blister like discharge’ afterwards so I wouldn’t worry.

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  5. I just had this procedure done 4 days sgo. After 2-3 years of monitoring (first I had cryo performed by another doctor), my current doctor stronhly suggested this procedure. I was nervous but after discussing my condition with friends, I discovered that I was not alone. Maby of my friends underwent this procedure. Some even had to be under anesthesia. But fortunately my doctor was able to perform this procedure in his office. It was fast. The longest part wss the setup. I didn’t feel any pain. I felt only presdure ftom the injection of the local anesthesia. So now I have to wait for the followup exam and the next papsmear. But thank God the worse is behind. I am now urging all my friends to get their yearly paps. Many illnesses such as cancer can be prevented. I have a dear friend who is currently battling cervical cancer . She didn’t get her yearly paps. So please talk to your friends, families and loved ones. The greatedt gift you can give another female is the gift of prevention. Everyone be well and thank you fof allowing me to share my story.

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  6. I had a LEEP done at 20 for a virus I picked up overseas. Anyhow, the most uncomfortable part of the whole thing was the colposcopy 10 days prior, but it was vet, very brief. During the LEEP, my Dr. was only going to do a general anesthetic (which probably would have been fine as I wasn’t feeling ANYTHING), however I got a bit distressed when I could smell the tissue burning and they immediately “put me under”. It was very mid general, like twilight, no ET (endotracheal tube in the throat) or anything. Was discharged a few hours later with instructions similar to other posters. No sex, tampons, douching, soaking or swimming for 3 weeks, and have completely normal Paps every three months following for 1 year, every 6 months for another year and them annually. That was over a decade ago with no more abnormal results!

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  7. I had the letz procedure just over a week ago now. I was quite nervous but I can honestly say that I didn’t feel the local anaesthetic administered. The nurses were really nice talking to me to take my mind off it and reassuring me. The procedure was over really quickly with minimal discomfort. I only had a slight discharge afterwards and now a week later I am having slight bleeding and a little cramping pain. I would like to say that my experience having the procedure was ‘nothing to worry about’. I think the thought of undergoing the procedure is worse than the actual experience.

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  8. I will be going for LLETZ on 20 September and I just came across this site. Thanks for your posts, now I have a fair idea of what to expect. A few questions though, how long does the actual procedure take (roughly how many hours will I spend in the hospital)? I’m also planning to drive myself to and from the hospital as DH will be away, will I not be too drowsy to drive? Doc didn’t say whether it will be local or general aesthetic. Also, I had abdorminal hysterectomy 9 weeks ago and am still in some pain, hope I’ll be able to manage afterwards being home alone. Thanks.

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    Hazel Rogers Reply:

    You definitely need to have someone drive you home following surgery. Your health is important. I was also told not to sign any important papers requiring decisions during the first 48 hours as well. I’m having the procedure done on Nov. 13 and my partner is more worried than I am. I’m lucky I have him to take care of me, although I’m told I won’t require much care at all.

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  9. Hi, I thought I’d share my story so it might help someone who’s worried about it. I had an abnormal smear and positive for hpv 6 years ago, then following the results of a biopsy (which revealed high risk precancerous cells), I was at my gynos office where she said to me you can either be booked into hospital and put under general anesthetic for the LEETZ procedure or you can suck it up and just get it over and done with right now. So I figured I’d just get it done then and there. She gave me local anesthetic injections which were extreeeeemly painful and then the operation itself hurt a lot as she couldn’t get it numb even after 4 needles. I know its not the same for everyone but I have since wished I had just waited and been put under GA as since this 6 yrs ago I’ve been back for just a colposcopy and smears 6 monthly for 2 yrs then yearly since and I have horrible anxiety leading up to my appointments because I can still remember the pain. But on the positive side, since the initial operation 6 years ago I’ve gone on to have a beautiful baby girl and am now 9 wks pregnant with my 2nd (and just had my annual colposcopy today which my dr said was fine to have while pregnant). Unfortunately I did have to have an emergency csection with my daughter after 30hrs of labor as I could not dialate, which I’ve been told since is most likely caused by scar tissue from the LEETZ procedure. For this next one I will be having an elective csection.
    So I guess my main points are – if you are worried and given the option, I’d go for the general anesthetic over local. You can still get pregnant after, although you could be like me and need a caesarean.
    And I’m now on my 6th year since having the initial procedure and haven’t had a bad result come back since (although I’m shit scared with anxiety everytime I have to go there!)

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    Bettina Reply:

    This was the information I was looking for. I was worried about how it would affect a pregnancy and delivery. You have confirmed the anxiety I was feeling. Is there anyone else who has experienced pregnancy and delivery complications due to this procedure? Has anyone had to have their cervix sewed shut to help along the pregnancy? Or were you forced to deliver early due to this procedure?

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    elisha Reply:

    I feel your pain! I’ve had two kids since my LEEP and was never able to dilate. My water even broke with my first and I had still not dilated or efface. I never linked the two together until I just saw this post.

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  10. hello.. I had my LLETZ done a few days ago. I was very scared but my doctor was happy to put me to sleep and come back as a day patient. I feel asleep… woke up and couldn’t feel a thing. Ive had a few cramps and mild bleeding. other than that everythings fine. I have to wait 4 weeks for my results. If anyone else noticed a smell or strange discharge before the LLETZ and then nothing after and every thing is now smell free, please can you mention.

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  11. First of all, love this site! It’s great to have access to all this information and I wish I would have had it 10 years ago.
    I underwent a LLETZ procedure in 2003 after yearly pap smear showed abnormal cells which after biopsy proved to be CIN III. Local anesthetic was not an option I was offered but given others experiences, I’m glad that I had general. I was a little stressed about it all, maybe a lot stressed would be a better description, but it was a walk in the park. I had no pain afterwards, although I panicked when I had heavy bleeding later the same night which turned out to be my period coming a little early. I’ve learned since that my body likes to have periods when I’m stressed. Anyhow, that was a little over 10 years ago and 19 months ago I gave birth to a beautiful baby boy. I was prepared for having a cesarean but lo and behold I didn’t need to, labor was 12 hours from start to finish, pushing for 1 hour. That was the point of this long winded comment, just wanted to say that natural birth is not impossible after the LLETZ procedure, it wourked out great for me and hopefully for everyone else who has to undergo this. The only problem after birth was it took a while for my cervix to fully close but now all is good and most recent pap smear shows no abnormailies. :) Stay healthy and happy!!!

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    Bettina Reply:

    Oh great! You answered my worry completely! I just posted asking for info on whether a c-section was a certainty afterwards but I guess it is not always. Thanks!

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  12. Am booked for a Lletz procedure in 2 weeks, Im 53 and always had normal paps until the last one, biopsy revealed high abnormality. I am relieved to read letters from other women about what happens and it seems to be relatively easy day op. I will be having a general. Thanks ladies!!

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  13. Hi, my first abnormal Pap was CIN1, 3 months later I had another Pap and a biopsy, the results came back as CIN 1,2 & 3. I was terrified at the speed in which the results had changed. I had the LETZ procedure, I was given a local anaesthetic, I felt the sting of the needle then my legs began to shake, the nurse said this was normal, something to do with adrenalin! The whole procedure was completed within 20mins. The staff where great, I was very nervous and emotional but they talked me through everything. When the procedure was completed they explained what I would experience in the coming weeks. They where spot on!! I bled heavily for a few days then lightly for 4wks. After 1wk I started to lose this awful black stuff that looked and smelt like burnt rubber. I then had a smelly discharge, I can only describe this as smelling like a wet dog! They didn’t gloss over anything and gave it to me straight. I was glad of this as when it all happened I wasn’t worried. That was 3 years ago, I’m still on 6 monthly Pap tests. So far so good.

    If the colposcopy nurse hadn’t explained everything to me I would have been an emotional wreck. As it was the whole experience wasn’t as bad as I’d imagined and far better than the alternative.

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  14. This website is very informative to any woman or man who wants to know more about cervical cancer.

    I had a colposcopy done 2 days ago it wasn’t painful at all I just had a little discomfort and the doctor used and iodine solution which has left a scab on the inside and outside of the vagina. Will the scab be passed out of the vagina naturally since it is self cleaning and if so how long will it take?? Or do I have to use my fingers to remove it ….I’m fearful that the iodine solution scab may cause me to get an infection

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  15. I had an abnormal smear test in September showing minor changes of the cells and then was booked in for a copoloscopy on 6th November. It was fine and she said she can either do the loop treatment now or take a biopsy and see what that comes back as but would be better to do now. This was fine but i have now received a call to confirm my follow up copoloscopy appointment in 4 weeks from the date of the last one. Is this normal?

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  16. i had lletz procedure 10wks ago for cin3. i had just finished my period the day b4. 1wk or so after i took another period which was very dark in colour. unfortunately i did not listen to the advice that was given to me had had intercourse after this. im now 9wks pregnant and still have some slight blood stain after intercourse. is this normal?..p.s..i had antibioctics to help the healing process and biopsy came back with no cancer cells

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  17. I had the letz procedure done yesterday and went under local anesthetic I was very nervous about the procedure but it didn’t take very long I felt fine afterwards even today I feel fine the only thing I’ve noticed is having discharge that smells a little bit I hope this is normal as I’ve never had a smell from there before. ;(

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  18. I had a colposcopy performed about 4-5 years ago. I miscarried last February and I sometimes wonder if there was scarring or something wrong with my uterus from this procedure. Has anyone heard of that? It was my first pregnancy so I have nothing to compare to. Thanks

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  19. Thank you so much for all the information shared in here ladies. I am booked for an LLETZ this morning – and I’ve stumbled onto this website as I was very anxious about the surgery. Reading testimonials of other women that have gone through the same procedure reassures me. Will post after surgery .

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  20. Today i had a Lletz procedure after a pap revealed HPV and cin 2 squamous cells.I had a general anaesthetic as he tried to do biopsy in his clinic but because i have gone through menopause my cervix was too flat to get a good amount if tissue out,I feel ok at home now but very emotional,I hope to have a clear papsmear next time its done.

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