Pre assesment for Lletz & GA

Hi Everyone,


I am new to this site - I had my second smear ever 8 months ago where it came back with abnormal cells so I was refered to the Colposcopy department at the hosptal. The took a biopsy and sent it off to the lab. The biopsy was so painful and I almost passed out with the pain (probably didnt help that I hadnt eaten that morning).

They called me back 6 months later (3 weeks ago) and said that they will just do a routine smear to see how the cells look and that I wouldnt need another biopsy that day (much to my relief). After the smear we sat down and she said that the area looks like it had gotten a bit better so she asurred me that I probably wouldnt need to come back until next year as the cells look like they are sorting themselves out.

Yesterday I receive a letter for a pre assesment on Friday 28th Aug. The letter was so crypitc and I never even got a letter with my smear results so I was a bit confused. I rang them this morning and they said they couldnt offer me my results as the nurse wasnt in but it looks like I will need Lletz treatment. I am so devistated, I thought all was good and I cant bare the thought of the procedure. I know it needs to be done and I will 100% do it but I dont think I will be able to cope with just a LA as I get to nervous and panic.

My question is, what should I expect in a pre assessment and will they do the procedure on the day or book another appointment?

Also am I able to request a GA or will they just do a local? I am so scared I cant even talk.

Ant advice would be amazing.


Thanks ladies xx

Hi Amanda

You poor thing, you sound terrified. I know how that one feels - I was much the same at the start of all of this.

Right, so the letter mentions a pre-assessment? As far as I am aware, they only do that for treatment under general anaesthetic. As you can see from my details below, I have attempted both LA and GA, and certainly no-one did any kind of pre-assessment for the LA. So let's presume it's for a procedure under GA. The pre-assessment won't be on the same day as the procedure, because they need to get the info that they record over to the hospital before you turn up there. My pre-assessment consisted of lots of questions (have you ever suffered from this and that), height and weight measured, blood pressure checked and then they took blood (YUK) as they need to know your blood group just in case you start to bleed and need a transfuion (she assured me that she has never known this happen, but it is a medical possibility, so they have to prepare for it).

If they suggest that they are going to do the LLETZ under local, you can request a general instead, and I really would if I were you. You shouldn't have to fight for it, but remember at the end of the day you have the last word, because if you don't consent to the procedure, they can't do it. Therefore if you have to dig your heels in, you have the ultimate sanction, which is to refuse consent unless it's under GA :-)

I found the biopsies quite fine, didn't feel a thing in fact, so was beyond surprised when I went for LLETZ under local and each time my doctor (who was absolutely lovely, btw) tried to inject me with the local anaesthetic, I shrieked and pretty much jumped a few feet in the air. At this point she said "I know you don't fancy a GA, but we are not in the habit of traumatising people, and this is really not working, is it?". If you found the biopsies so painful, I really wouldnt suggest that you try LLETZ under LA!

Which brings us on to the alternative: GA. I found it pretty fine. I remember saying "ooh, I can feel that anaesthetic going in" and then the next thing I remember is waking up in recovery. I didnt feel bad at all after the GA, but you're only out for about 10 mins apparently. I just felt like I do when I wake up in the morning. Also they give you some painkillers in with the GA drugs, so no pain afterwards. In fact, I didnt really feel any discomfort. I took over-the-counter painkillers for a few days after, and that's it. I am 2.5 weeks in now and obviously things are still healing up, but all feels exactly as before "down there".

Take a deep breath hun, you'll be OK, really you will. If you need to ask anything else, you'll find loads of people on here who can help you

x x



Hi Elise,

Thank you so much for your advice, its been so much more helpful than anything the hospital could tell me. That is so strange about the pre assessment though, do you think it is anything serious as to why it might be a GA procedure? I will be quite glad if it is as that is definitely what I am going to opt for.

Its not even the pain that bothers me so much, its how panicy and nervous I get before and during. I mean a smear isnt the most comfortable thing in the world but the biopsy was horrible. I didnt hear the nurse say caugh so Im laying there trying to relax and I could feel the cut and then I had a horrendous shooting pain go from my groin to my stomach and back down again followed by nausea and then wanting to pass out - oh and mild period like pain.

From that experience alone I would just much rather have a GA for my own peace and sanity lol. 

Thank you again for your advice, Im glad I can share similar experiences with so many woman, albeit horrinle ones.

Amanda x

Hi Amanda

I don't think they are doing GA because it's anything horribly serious, no. My nice doctor phoned me before my appointment for LLETZ under local, because she knew that I have a medical phobia and thought that I might struggle with it, and offered me the option to choose a GA. I was the same, panicking and asking her why she wanted to do it under GA, is it a really big area or something? She just said no, it's not that, it's that we don't want people to leave here completely traumatised and if you think it'll be too much for you, it's no problem to have a GA instead.

In short, the doctor who did the colposcopy will have referred you for treatment, and if he/she saw that you were really nervous and struggled with the biopsies, has probably gone straight for GA just to avoid any unnecessary trauma for you.

The other thing to bear in mind is that they are removing a piece of your cervix, so I am sure that if you're pretty much having a panic attack while they're trying to do it, it doesnt exactly make it easy for them. I guess under those circumstances they would prefer to put us out and work on us while we're not jumping up and down and yelling :-D

Mine was CIN1 with some small patches of CIN2, and not covering a particularly big area, but they were still happy to do it under GA.

Good luck for your appointment, let us know how you get on