Large Loop Excision of Transformation Zone, LLETZ/LEEP

Indication

   High-grade squamous intraepithelial lesion of cervix

   Persistent low-grade squamous intraepithelial lesion of cervix

The Procedure

   All ornaments and metal objects, e.g. Wrist watch, earrings, have to be removed before the procedure

   Local anaesthesia or general anaesthesia

   Colposcopic examination of the cervix to identify the abnormal area

   An electro-surgical loop is used to cut out the abnormal area of the cervix

   Haemostasis with ball electrode +/- application of Monsel’s solution

   All tissues removed will be sent for pathological examination or disposed of as appropriate unless otherwise specified

Photographic and / or video images may be recorded during the operation for education / research / documentation purpose. Please inform the staff if you have any objection.

Risk and Complication

   Anaesthetic complications

   Electric cauterization

   Bleeding

   Secondary haemorrhage (5% chance)

   Infection (5% chance)

   Cervical stenosis (2% chance)

   Cervical incompetence

   Injury to surrounding organs such as the bladder

   Risk of recurrence (up to 10% chance)

   Increase in preterm delivery, low birth weight, premature rupture of membranes without apparent increase in neonatal morbidity

Risk of Not Having the Procedure

   Persistence of the disease

   Progression to cancer of the cervix

After the Procedure

   May experience some vaginal bleeding and lower abdominal discomfort for up to 4 weeks after the operation and may have an increased amount of bleeding on Day 7-10 after the operation

Alternative Treatment

   Cone biopsy

   Hysterectomy

Follow Up

   Avoid swimming, intercourse, bath or use of tampon for 6 weeks after the procedure to reduce the risk of wound infection

   Seek medical advice immediately if vaginal bleeding becomes heavy

   Regular cervical smears follow-up

   There is no evidence that a single treatment has any adverse effect on a woman’s future fertility

Remarks

The information contained is very general. The list of complications is not exhaustive and other unforeseen complications may occasionally occur. In special patient groups, the actual risk may be different. For further information, please contact your doctor.