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  • Q&A with Australian Health Practitioners

    Approx how much tissue is removed with Lletz procedure?

    I'm soon to have a Lletz procedure for cervical cell changes. Was just wondering how much cervical tissue is removed during this? Can having a Lletz lead to any future problems such as pain with sex or using tampons, or trouble obtaining enough cells in future pap smears? Thankyou.
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    Dr David Moore

    Gynaecologist, Gynaecologist - Infertility (IVF) Specialist, Obstetrician

    David received a solid foundation to training in tertiary obstetric units and has developed skills in the management of complex and high-risk pregnancies and deliveries. … View Profile

    Hi there,

    The amount of tissue removed during a LLETZ procedure will depend on the size of the lesion being treated and your age, but is generally small (e.g. 15mm diameter, 6-8mm deep).

    In younger women who may plan pregnancy in future, we would generally aim to preserve as much normal cervical tissue as possible while, in women who have completed their family, we may aim instead for definite “clear margins” of excision, requiring a slightly larger specimen to be removed.

    It is recommended that the gyaenecologist performing the LLETZ should perform a colposcopy (like when you had the biopsy taken) at the time of the LLETZ, to maximise the chance of complete excision of the lesion, and avoiding an unnecessarily large area being removed.

    Pain with sex should not be a problem in future, nor will using tampons.  In the short-term, however, your doctor will probably recommend abstaining from sex or the use of tampons from 4-6 weeks, to reduce the risk of infection.

    Obtaining cells in future Paps is rarely a problem, although sometimes the area of interest (called the “transformation zone”) may be difficult to fully examine with the colposcope after a LLETZ treatment.

    There is a slightly increased risk of preterm birth after a LLETZ procedure, although the absolute risk remains small and the outlook for pregnancy remains very good.  There is also some evidence that the risk of preterm birth may be related, at least in part, to the presence of HPV and the CIN lesion itself, rather than the LLETZ.

    I hope that helps, good luck with your procedure!


  • Anonymous

    That was a very comprehensive answer! Put  my mind at rest, thankyou for the explanation :)

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