GHPI0790_08_13
Author: Colposcopy
Review due: August 2016 www.gloshospitals.nhs.uk
BETTER FOR YOU
BETTER FOR YOU

The purpose of this treatment is to remove an area of abnormality on your cervix (neck of womb), which has been diagnosed from the tissue sample taken at your last appointment.
The grade of abnormality reported is referred to as
Cervical Intraepithelial Neoplasia; which is more commonly referred to as CIN. Please refer to the leaflet
GHPI0298 The Colposcopy Clinic booklet sent with your appointment, as this discusses CIN in more detail.
Your biopsy results may have shown either CIN 2 or CIN
3, or persistent CIN 1.
CIN 1 – these are relatively minor changes with a very low risk of proceeding to cancer and will usually return to normal by themselves. Treatment is not usually necessary unless it continues to be persistent.
CIN 2 and 3 and CGIN (Cervical Glandular Intraepithelial
Neoplasia) – These are more definite changes and, if you have not already had treatment at your first visit, you will normally be asked to come back to have the abnormal area removed.
Large loop excision of transformation zone (LLETZ) is the most effective treatment for CIN. Local anaesthetic is used to numb the cervix. This ensures that no discomfort is felt during the treatment.

If the appointment date is inconvenient or you are going on holiday soon after, or it is likely you may have a period, please rearrange the date as soon as possible to enable us to give the appointment to someone else.
For further information, please contact the colposcopy clinic on:
Cheltenham General Hospital and Cirencester
Hospital:
Tel: 0300 422 2385 (advice line)
Tel: 0300 422 2914 (appointments) (Monday to Friday,
9:00am to 5:00pm)
Gloucestershire Royal Hospital and Stroud Hospital:
Tel: 0300 422 2385 (advice line)
Tel: 0300 422 5508 (appointments)
(Monday to Friday, 9:00am to 5:00pm)
Please may we remind you that we are unable to give out results over the phone.
NHS CSP Publications
Website: www.cancerscreening.nhs.uk
Jo’s Cervical Cancer Trust
Helpline Tel: 0808 802 8000
Website: www.jostrust.org.uk
This treatment removes the abnormal tissue with a small wire loop which has an electrical current running through.
This allows the tissues to be removed from the cervix.
The cervix is then sealed with the electrical current to keep bleeding to a minimum. This procedure takes approximately 15 minutes, and is usually performed in the same setting as your first appointment.
If you have an Intrauterine Contraceptive Deceive
(IUCD), also known as the coil, sometimes it may be necessary for it to be removed so that treatment can be performed. However, treatment can still be performed in most cases with the coil in place. The side effects of this are that the coil threads may possibly be cut through during treatment, thus making the threads shorter. We therefore recommend you either abstain from intercourse, or use condoms for seven days prior to your appointment, to prevent the risk of pregnancy occurring.
Options will be discussed with you in more detail at your appointment. If we need to remove your coil, your doctor can insert a new one six weeks after your treatment.
However, you should ensure that alternative contraception is used or abstain from sex until your new coil is fitted.
You will have an injection of local anaesthetic to numb the cervix before the treatment is performed. Severe pain following treatment should not occur. You may experience some discomfort (similar to period pains) afterwards for which we recommend simple pain relief such as paracetamol (please use according to the packet instructions).

Most women are able to return to their normal activities the same day. For the first week following treatment, some women will experience bleeding similar to a period, followed by a blood stained vaginal discharge, which may continue up to three weeks. This is a normal part of the healing process. You may need to wear a sanitary towel during this time.
The cervix takes three to four weeks to heal and to reduce the risk of infection, tampons, intercourse and swimming should be avoided until the discharge has subsided so that healing is uninterrupted. Normal showering and bathing should continue during this time.
Should you experience any heavy unexpected bleeding during this time, or an offensive smelling discharge, please contact your GP for advice.
The tissue removed from your cervix will be sent to the laboratory for further analysis. The results will be sent to you and your GP within two to four weeks, together with information about any follow-up that may be required.
In 95% of women, a single treatment is all that is needed to cure the condition. However, in about 1 in 20 women, this problem can reoccur. Follow up to make sure you have been successfully treated is extremely important.
All women who have a treatment will be followed up with smears at six months after their treatment. The cells examined will also be tested for the presence of High
Risk HPV (HR HPV) to ensure you have been completely treated (please see leaflet GHPI0787 Human
Papillomavirus (HPV) information and fact leaflet).
If HR HPV is not found, and the smear test is reported as negative, mild or borderline, then you will return to having either three or five yearly smears depending on your age.
If HR HPV is detected or the smear test shows an abnormality, you will be asked to attend the colposcopy clinic for a further assessment.
If you are pregnant, then treatment will need to be postponed. Please contact the department to plan and re-arrange your appointment.
Some studies have shown a very small increase in the risk of pre-term delivery following LLETZ treatment.
However, other studies have shown that if you have ever had any pre-cancerous changes on your cervix, you are at a slightly higher risk of pre-term labour than another woman who has not had these changes. LLETZ is therefore considered a safe procedure and is recommended by the Department of Health for precancerous changes on the cervix.
We hope this leaflet has answered some of your questions and reduce your anxieties. However, if you require any further information, please do not hesitate to contact the colposcopy clinic on the numbers at the end of this leaflet.