Local Anaesthetic At least 80% of treatments should be performed in the colposcopy clinic with local anaesthetic. For a few patients it will be considered more suitable to admit her to hospital for day-case treatment under a short general anaesthetic. This does not necessarily imply that the problem is more severe or serious. For example it may be because laser treatment has been recommended, or if you were thought too apprehensive and nervous to have treatment under local anaesthetic. A local anaesthetic is injected into the cervix before any treatment is undertaken. This works extremely quickly and effectively. Usually three or four small injections are used. Any discomfort is usually momentary and often women cannot feel the later injections at all. It is sensible to take some simple pain relief such as Paracetamol or Ibuprofen afterwards as often women experience some period-like pain later when the local anaesthetic has worn off. LETZ Loop Excision of the transformation zone (LETZ) uses a fine heated wire loop to excise the abnormal area on the surface of the cervix. The colposcopist can select different sizes of loop and cut as superficially or as deep as required to remove the abnormal cells. This small piece of the cervical tissue is then sent for detailed analysis in the laboratory under the microscope. The transformation zone is the sensitive area on the cervix where abnormal cells arise. It is caused by the delicate glandular cells of the cervical birth canal being exposed to the more acidic environment of the vagina in adulthood. Loop excision is the most commonly used treatment at present, and has proved extremely effective and safe over the last ten years or so. It has largely replaced laser treatment which was commonly used in the 1980s. The treatment is simple, quick and can be performed under local anaesthetic, preventing hospital admission. See and Treat Often if it is clear following examination at your first colposcopy appointment that treatment is required. If this is the case you may be offered treatment by loop excision immediately. This in effect acts as biopsy and treatment in one stop, preventing repeated visits and unnecessary delay. ‘Cold’ Coagulation Despite the name this also uses heat to destroy the abnormal cells on the surface of the cervix. It is less hot than the heat generated by LETZ or diathermy. It is simple to use and very good for low grade cervical problems. It may be also use to control any rare troublesome bleeding from the cervix following treatment.