What is loop excision of the cervix?
Loop excision of the cervix, also known as loop electrosurgical excision procedure (LEEP) or large loop excision of the transformation zone (LLETZ), is a common procedure used to remove abnormal cells from the cervix. These cells may be detected during a cervical screening (smear test) and could potentially develop into cervical cancer if left untreated. The procedure is both diagnostic and therapeutic, meaning it can confirm the presence of abnormal or precancerous cells and treat them by removing them.
Why is loop excision performed?
Loop excision is typically recommended when:
- Abnormal cervical cells are detected: If your cervical screening indicates the presence of abnormal cells (also known as cervical intraepithelial neoplasia or CIN), loop excision may be recommended to further examine and remove these cells before they can develop into cancer.
- Early-stage cervical cancer: In some cases of very early-stage cervical cancer (e.g. Stage IA1), where the cancer is small and confined to the cervix, conization may be sufficient to remove all the cancerous tissue.
- Preserving fertility: For women who wish to maintain their fertility, conization is a fertility-preserving option, as it involves removing only the affected part of the cervix rather than the entire uterus.
How is the procedure performed?
Loop excision is usually performed in a hospital or clinic setting and typically takes about 10 to 20 minutes. Here’s what you can expect:
- Preparation: You will be asked to lie on an examination table with your legs supported. A speculum is gently inserted into your vagina to allow access to the cervix.
- Anaesthesia: Local anaesthetic is applied to numb the cervix, ensuring that the procedure is as comfortable as possible. General anaesthesia is rarely required.
- Excision: A thin wire loop heated by an electric current is used to remove a small, cone-shaped section of abnormal tissue from the cervix. The loop excises the abnormal cells with precision and seals the wound at the same time with minimal damage to surrounding healthy tissue.
- Completion: After the abnormal tissue is removed, it is sent to a laboratory for further examination to ensure all abnormal cells have been successfully excised.
Recovery after loop excision
- Post-procedure: You may experience some light bleeding, discharge, or cramping for a few days to a couple of weeks after the procedure. This is normal and should gradually decrease.
- Avoiding infection: To reduce the risk of infection, it is advised to avoid using tampons, having sexual intercourse, or douching for about four weeks following the procedure.
- Rest and recovery: You can return to normal activities within a day or two, but strenuous exercise and heavy lifting should be avoided for a week.
Risks and side effects
While loop excision is generally safe, there are some risks and side effects to be aware of:
- Infection: Although rare, there is a small risk of infection following the procedure. Signs of infection include heavy bleeding, unusual discharge, or fever. If these occur, contact your gynaecologist.
- Bleeding: Mild bleeding is normal, but heavy bleeding (soaking more than one sanitary pad per hour) should be reported to your doctor.
- Cervical incompetence: In rare cases, removing a large amount of cervical tissue can weaken the cervix, which may affect future pregnancies, increasing the risk of preterm birth.
Follow-up care
- Results: The tissue removed during loop excision will be analysed, and your healthcare provider will discuss the results with you, including whether further treatment is needed.
- Further screening: It’s important to attend follow-up cervical screenings as recommended by your healthcare provider to monitor your cervical health and ensure no abnormal cells return.
Fertility considerations
Loop excision generally has a low impact on fertility. Most women can conceive and have a normal pregnancy after the procedure. However, if you have concerns about fertility or pregnancy after loop excision, it’s important to discuss these with your healthcare provider.
Why choose Birmingham Gynaecology Clinic?
At Birmingham Gynaecology Clinic, we provide expert care for women undergoing loop excision of the cervix. Our experienced team follows the latest guidelines to ensure you receive the highest standard of treatment. We offer personalised care, ensuring that each you feels supported and informed throughout the entire process.
Contact us
If you have any questions or would like to schedule your procedure, please don’t hesitate to contact us today. Our team is here to provide the care and support you need.