$Unique_ID{BRK02467}
$Pretitle{}
$Title{Are PAP Smears Needed After Hysterectomies?}
$Subject{pap hysterectomy removal uterus cervix subtotal test screening tests
smears genitourinary system special procedure procedures lab laboratory smear
hysterectomies removed remove papanicolaou}
$Volume{J-14,P-14}
$Log{
Abrasion Biopsy of the Uterus*0001901.scf
Total Hysterectomy*0008601.scf
Partial Hysterectomy*0008602.scf
Diseases of the Female Reproductive System*0009001.scf}

Copyright (c) 1992,1993   Tribune Media Services, Inc.


Are PAP Smears Needed After Hysterectomies?


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QUESTION:  Though I had my uterus removed many years ago, my doctor still
insists on my having a PAP test from time to time.  I ask him why I need this
test now, but he just smiles and tells me to take his advice.  Do you think
there is any need for this in a woman in my present condition.

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ANSWER:  I wish you had provided me with a bit more information about your
"present condition" and had told me the reason for your hysterectomy (removal
of the uterus).  This information is essential in judging the value of a PAP
test for women after the operation.  It may well be that though your uterus
was removed, the tip of this organ, the cervix, was left in place.  This is
called a "subtotal hysterectomy" and was widely practiced in the United States
before 1960.  There are still many women alive who had this surgery.  In such
situations, continuing the practice of regular PAP screening tests is consider
essential, as cancer may develop in the tissues of the remaining cervix.
     While there are no absolute rules concerning the continuing of PAP tests
after hysterectomy, recent guidelines developed in Canada may help answer this
question for many women.  If the hysterectomy was performed for a benign
condition (noncancerous) and if all of the cervical tissue was removed, and
finally if there is documentation that the PAP smears of the cervix taken
prior to surgery were all normal, then continued PAP smears are not considered
essential.  Obviously your present doctor must have all that information
available to him, if such a decision is to be made.  Without all that
documentation, most physicians would feel that prudence demanded that the test
be continued.  It certainly is the best way to be sure, and anything we can do
to diagnose cancer in the earliest stages, when treatment is most effective,
is to be recommended.

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The material contained here is "FOR INFORMATION ONLY" and should not replace
the counsel and advice of your personal physician.  Promptly consulting your
doctor is the best path to a quick and successful resolution of any medical
problem.