Biopsy, Cone Biopsy, LLETZ


What a wonderful forum! This has truly been a God send to me recently. I've not posted but have been reading whilst awaiting my colposcopy and it's been so helpful.

So, first post, and I'm hoping somone could help me with a query.

I recently had a colposcopy, during which the consultant took a biopsy. I am currently awaiting the results of it and obviously going completely out of my mind with the wait.

In the meantime I've been trying to educate myself. I know pre-empting and googling are dangerous things and everyone keeps telling me to "just take one step at a time", but it simply isn't how I work and having an idea as to what I might encounter makes me feel slightly less helpless.

I keep coming across information regarding biopsys, cone biopsys and LLETZ and whilst I understand what they are and what they are used for, I'm confused about the circumstances they're used in. Some people seem to have been given a cone biopsy for example as a 'first step' whilst others seem to have just a biopsy, and others have all 3 at one time or another.

Could anyone please clear this up for me?


Hi GeorgiePorgie! Welcome!

I think I speak for a lot of us when I say we all want to be able to take it one step at a time; we know it would be sensible....but it's not that easy. You'll already know that there are lots and lots of people going out of their minds with the wait. I agree that a certain amount of information helps you feel more in control. Just don't go on a Google spree!

What I've noticed is that every healthcare team does things differently. In my case, I went for a colposcopy because they'd found CIN3. They already knew they were going to treat me with LLETZ and had told me that in the letter. I also knew that they would be sending a biopsy off and I would get the results within 4 weeks. (I actually got a call asking me to go in for an MRI after 3 weeks, before having been given any results. That was pretty shocking!)

Anyway, I think they might always do a biopsy at a colposcopy so that they can have a good look at what's going on at a cellular level. I think it might depend on how abnormal the cells are as to whether they do the LLETZ there and then. The truth is, I only know what happened to me but maybe there are others who can tell you about their experiences. and reasons for having cone biopsies. I'm sure we can all get together to make you feel a bit less helpless! :) The waiting is awful - you have to try and distract yourself as much as possible. Good luck!

Kirsty xx

Hi Georgieporgie

I had LLETZ at my colposcopy too.  My routine smear results came back severe abnormalitles and in the letter it said I was booked in for the colposcopy and they may or may not treat there and then, dependant on the colposcopist. 

When I arrived the doctor said it was my choice at that stage, I could have the treatment just in case, or they could do a biopsy without treatment and see if i was in the lucky 5% that wouldn't need treatment. 

He explained that in c95% of cases with severe abnormalities then treatment will be required, and of those c95% of people who then have treatment will go on to be fine afterwards and not need anything further.  He listed out the pro's and con's of LLETZ, explaining everything in plain english.  I interrupted him to begin with and said I just wanted the treatment straight away, but he asked me to listen to everything he had to say first! He was very nice and reassuring but also very honest which i reallly respected.  This is all in consultation at a desk before moving to the treatment area.

The treatment was unconfortable and a little undignified, but nothing to be scared of! There was also a nurse there whose sole job appeared to be 'hand holder' - they really do look after you! The worst part is actually the waiting afterwards.

I hope that helps a little.






Hi Georgie,

I think it can depend on a lot of factors. Although LLETZ is actually not that bad on the scale of things, it would be cruel to put you through it unneccessarily. In my case my smear said severe abnormalities and they seemed pretty confident that is what it was, I have had my family and was not worried about future pregnancy etc so I think it was just a case of getting it done as soon as possible at my colposcopy. I was insistent that I didnt want to come back if I could avoid it! 

I think if you are quite young and the abnornality doesnt look too bad/ big maybe they use a biopsy as a first port of call to determine if you may need further treatment. I think quite often a biopsy can be enough if it is just a small area and they get it all in one go. If they feel there might be a little more to take away I think they would then call you back in for LLETZ or cone. Mine was a big area.

Essentially what you have had done is a smaller version of LLETZ. All of the methods are sent away for biopsy and entail this hellish wait. Hope they dont make you hang on too long and let you know the next course of action (if any) as soon as possible.

Big hugs



Yeah, the colposcopy is just a magnified look at the area, often applying a solution to identify the abnormal cells. 

Biopsy is taking a very small sample of tissue with the abnormal cells, without any LA, using a punch biopsy - normally to confirm the smear result and work out which treatment is best (or that none is needed). Often happens at the colposcopy appointment.

Lletz is a procedure that removes the abnormal cells and allows them to analysed, normally under LA but sometimes GA.  Can happen with or without biopsies being taken first.

Cone biopsy is  often used to remove and test a larger/deeper area of abnormal cells, they remove a cone shaped area generally under GA.  Sometimes this is the first treatment, sometimes it is used after a Lletz that didnt get clear margins. (My case).

Hope that helps.  xx