Question: Pap Smears After a Hysterectomy
Do I need to continue to have Pap smears if I have had a hysterectomy?
Answer: Women who have had a hysterectomy may still need to have regular Pap smears. This varies, depending on what type of hysterectomy was done and the reason it was needed.
A hysterectomy is the surgical removal of the uterus. The uterus can be removed through the abdomen or vagina. A hysterectomy is often done to treat gynecological cancer, but is also used to treat benign conditions, like fibroids and endometriosis.
Abdominal vs. Vaginal Hysterectomy
Women who have undergone an abdominal hysterectomy may still need regular Pap smears because the cervix may still be intact. There are also instances where the cervix is removed during an abdominal hysterectomy.Women who have had a vaginal hysterectomy, however, may not need to continue having regular Pap smears because the cervix is always removed during a vaginal hysterectomy.
Hysterectomy Due to Cancer
It is recommended that women who have undergone a vaginal or abdominal hysterectomy to treat cancer continue to have regular Pap smears. Women who are at high risk of developing cervical cancer should also be regularly screened, regardless of the type of hysterectomy performed.Note: All women need to have annual pelvic exams, whether they need a Pap smear or not.
When the Cervix Has Been Removed
A Pap smear is a highly effective means of cervical cancer screening, even when the cervix has been removed.During a Pap smear, the doctor collects a sample from the vaginal cuff, an the area in the upper vagina where the cervix was once located.
When in Doubt, Ask Your Doctor
Remember, your doctor is your best source of health information. After a hysterectomy, ask whether your cervix was retained or removed. Although your doctor may have clarified this prior to surgery, there are times when during surgery, the doctor decides to remove or retain the cervix.If you are unsure about whether your cervix has been removed or not, ask your doctor.
References:
- "Pap Test." WomensHealth.gov. Mar 2006. U.S. Department of Health and Human Services. 19 Feb 2007 <http://www.4woman.gov/faq/pap.htm#pap06>.

