Atlas of Colposcopy: Principles and Practice

Large loop excision of the transformation zone (LLETZ), also known as loop electrosurgical excision procedure (LEEP), is the most commonly used procedure to treat cervical precancerous lesions.

The cervix is covered with necrosed slough for a few weeks after LLETZ. Gradual healing takes place by regeneration of the epithelium from the periphery, which can be seen after 2–3 months. Colposcopy should not be performed before at least 6 months after LLETZ, to allow the healing process to be completed. Once complete healing has taken place, the cervix may have a whitish appearance at the centre because of fibrosis. Rarely, there may be stenosis of the external os. Most of the time, the cervix heals completely and a faint area of scarring, which is visible at colposcopy, is left around the os.