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It’s odd but essentially pain-free (Picture: Getty Images)
Human papillomavirus (HPV) is something that eight in 10 of us will encounter at some point, which is why Metro.co.uk is shining a light on the virus this week as part of our You, Me & HPV mini-series.
HPV isn’t tested for in a standard sexual health screening, so it’s near impossible to know when or where a person might have contracted it or who they might have passed it onto.
Most people will fight off the virus in one to two years without any lasting effects, though it can make others vulnerable to cancers of the cervix, anus, head and neck, penis, vagina, and vulva.
If cervical cell changes are detected during a smear test, you may be advised to undergo a Lletz procedure.
But what exactly does this entail?
Here’s what you need to know
What can you expect from a Lletz procedure?
I’d never even heard of a Lletz procedure before I had one myself late last year.
That might just be me, though. I also thought Mount Everest was in the Peak District until I was 22.
Reading up on the procedure before you go could help minimise your fears (Picture: Getty)
A Large Loop Excision of the Transformation Zone – or LLETZ for short – is the treatment most commonly used to remove abnormal cervical cells.
These are usually detected through routine cervical screening.
All women aged 25 to 49 are eligible for screening once every three years, rising to once every five years for women aged 50 to 64.
One in 20 women will get an abnormal result and some, like me, will be referred on for further investigation.
The pre-C word
We need to take a moment and talk about abnormal cells, also referred to as precancerous cells.
These are not cancer and they do not mean you are going to get cancer
Just over 3,000 cases of cervical cancer were diagnosed in the UK in 2015, according to the latest figures from Cancer Research UK, which is a relatively tiny figure when you consider that there are over 32 million women living in the UK.
It’s normal to feel anxious about precancerous cells – cancer is built right into the title – but they are simply cells that, if left untreated, may require attention in the future.
If you have an abnormal result, it is likely you will be referred on for a colposcopy, a procedure in which a small microscope is inserted into the cervix.
Some of your cells are taken and examined under a microscope (Picture: Getty)
It is performed in hospital and I am happy to confirm it is painless.
You may, like me, have a biopsy at the same time, where a small section of cervical lining is removed and sent off for analysis.
Despite how it sounds, this is also pain-free.
Let’s talk about Lletz
Three weeks after my colposcopy, the results were in.
I had mild to moderate precancerous cells and would need a Lletz procedure to have the cells removed.
Alternative treatments include cryotherapy, when the cells are frozen, and targeted laser treatment, but Lletz is by far the most usual, and it’s safe, quick and highly effective.
I arrive for my Lletz on the allotted day and am soon ushered into a private room by a very lovely nurse.
I strip from the waist down – I mean, she asked me to – hop up on the bed and put my feet in the stirrups, exposing my vagina to all and sundry.
If there’s one thing I’ve learnt along my gynaecological journey, it’s that you might as well check your embarrassment at the door.
It can be nerve-wracking, but the procedure is quick and easy (Picture: Getty)
Not only have all the medical staff I encountered been exceptionally professional, there’s no point in feigning decency when you’re pants off, legs up.
I say, lie back and enjoy the breeze.
First up – literally – was my old pal the speculum, fully lubed up and ready to open up my cervix.
It doesn’t hurt but it does feel unusual, like your vagina is trying to yawn.
Next was the same type of microscope I had met at my colposcopy. A second nurse switched on the TV monitor by my head and, suddenly there was the inside of my cervix in HD.
‘You don’t have to look,’ said nice nurse number two. But I was transfixed, because how often do view your own innards?
Lovely nurse one dabbed dye on the abnormal cells to make them show up in white, and engaged me in light chitchat as she worked.
We talked about my work, her daughter and the extortionate cost of train travel.
While it sounds like an odd scenario for gabbing, I found the whole process went more smoothly if I relaxed, did a bit of deep breathing and thought about South Western Rail.
A small prick in my vagina
Before the cells can be removed, the area must be injected and numbed with local anesthetic.
A colposcopy is often done if cervical screening finds changes to your cells (Picture: Getty)
I’ve had similar injections before in everywhere from my gums to my elbow, so this was the part I was dreading.
And while it wasn’t exactly comfortable, it really was only the faintest of stings, and it was all over in seconds.
As we waited for the anesthetic to take effect, nurse one explained how the Lletz procedure works.
She would use a small metal loop heated by an electrical current, and apply it to affected area, cutting away the cells and repairing the tissue in one go.
In any other circumstance, the words ‘metal loop’, ‘electrical current’ and ‘inside your vagina’ would have had me scrabbling for the door but as nurse two explained, the worst bit is the noise of machine.
Indeed, when she turned it on, it sounded like a vacuum cleaner when the nozzle snags on the curtain.
The Lletz itself was entirely pain-free.
All I felt was a bit of pressure and an odd sense of buzzing before nurse one announced she was done, and concluded with a final check that all the abnormal cells were gone.
She handed me a large sanitary pad and left me to get dressed.
Discharge is normal after Lletz and can vary from light spotting for a few days to a watery substance or a rust-coloured discharge that lasts for a few weeks.
Lletz procedures take around 15 minutes (Picture: Getty)
It’s advised that you don’t have sex or use tampons for a month, and to contact the hospital if you develop symptoms such as pain or heavy bleeding, both of which can indicate infection, but are rare.
Without going into too much detail – you might be eating – I was on the rusty end of the spectrum but found that panty liners were perfectly sufficient.
Back in the hospital room, nurse one was checking that I felt OK.
Nausea and dizziness are both normal after Lletz.
But, on the advice of a friend, I’d come armed with a banana and can of Diet Coke.
I highly endorse this, though the choice of beverage and fruit are, of course, up to you.
Also, if you get home and feel a bit tearful, don’t be alarmed – I did.
Gynaecological procedures are inherently invasive and can leaving you feeling shocked and vulnerable, not to mention sore.
After the procedure, it is common to have cramping that feels similar to menstrual pain (Picture: Getty)
I was also struck by how little we talk about these things, and how anxiety-provoking they become as a result.
Let’s arm ourselves with knowledge, share our experiences and offer reassurance to our sisters, daughters, colleagues and friends.
Let’s remove the mystery and assuage the fear, so that we can go into a Lletz procedure knowing what to expect.
You, me & HPV
This week, Metro.co.uk is looking at HPV and its related cancers from a range of perspectives.
By and large HPV isn’t something to worry about – but it is something to be aware of.
HPV is something that eight in 10 of us will encounter at some stage of our lives. It’s spread through skin-to-skin contact, not just penetrative sex. There is even some evidence to suggest it can spread through deep kissing.
It isn’t tested for in a standard sexual health screening, so it’s near impossible to know when or where a person might have contracted it or who they might have passed it onto.
For most people, their bodies will fight the virus off in around one to two years without any lasting effects. For some people however, it can make them more vulnerable to cancers of the cervix, anus, head and neck, penis, vagina and vulva.
Over this week, we’ll be exploring the human issues that come with HPV and its related cancers.
Share your views in the comments below