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An_249059 posted:
Hi Jane,
I am 68 and had a hysterectomy over a year ago. Do I still need to have PAP tests?
Thank you, so much.
georgiagail responded:
This would depend on several factors..

First, was your cervix removed during this surgery? If so, there is nothing left to "smear" for a Pap test (this test checks for abnormal cells on the surface of the cervix).

Second, was the hysterectomy done because of cancer of the cervix? If so, follow up Pap tests to check for any abnormal cells near the top of your vagina is often recommended, just to make certain all of the offending cells were removed during the surgery.

BREN34748 replied to georgiagail's response:
Thank you for responding, Gail.

My hysterectomy was done because of a prolapsed cervix. So, the cervix was removed, I believe. I never had an abnormal pap test. The ovaries were not removed.

Thank you,
BREN34748 replied to georgiagail's response:
Sorry, Gail. I had second thoughts. It may have been a prolapsed uterus. The Dr. said everything was removed but the ovaries.

Thank you,
georgiagail replied to BREN34748's response:
Then there is no need for further Pap smears since there is nothing left to "smear".

BREN34748 replied to georgiagail's response:
Thank you, Gail! That is exactly what I needed to know.
Watercolor1600 responded:
From the Women's Health Center at the Cleveland Clinc:

A woman might not need an annual Pap smear, but she still needs an exam to check the vagina, the bladder, the rectum, the external genitals — and, of course, the uterus and ovaries, if if they haven't been removed.
Jane Harrison Hohner, RN, RNP replied to Watercolor1600's response:
Dear BREN, Gail, & Watercolor: Thanks to all for entirely correct information.

In Appreciation,
BREN34748 replied to Jane Harrison Hohner, RN, RNP's response:
Thank you, Watercolor1600 and Jane for the additional info.
I will get a check-up. So, glad you let me know that.

Watercolor1600 replied to BREN34748's response:
You are more than welcome.
Jannod replied to Jane Harrison Hohner, RN, RNP's response:
I don't understand your response to these women about a pap after hysterectomy? I had a complete hysterectomy in 1990 because of fibroid tumors in the uterus, heavy bleeding, and A--typical cells were found in my cervix. My doctors informed me that I would probably develop cancer in two years if I did not have the surgery. I continued to have my yearly pap smears after my hysterectomy, and several years later my GYN doctor found A-typical cells on the cuff of where my cervix was removed. I had moderate displasia, and he perfomed a procedure to remove the cells. He suggested I continue to have a pap every year, which I do. I am now 68. Why not just have the pap along with your exam for precautionary measures?
sjb05151956 replied to Jannod's response:
Your situation differs from the original poster's. She never had an abnormal pap and doesn't have a cervix hence no need for paps. You had atypical cervical cells prior to your hysterectomy which MAY have been pre-cancerous. (There are also relatively harmless conditions that can cause atypical cells and these oftentimes resolve on their own, no treatment needed.)

The progression of atypical cells to cervical cancer (if it even happens) generally takes many years so the current guidelines recommend screening every 3 years for those who're not at increased risk. Also, since most atypical cells resolve on their own, it's generally suggested that any abnormal pap be repeated before any treatment. Also to be considered is the wide range of experience of pathologists who interpret the paps, another reason for a re-do. Here are a couple of links:
Ashley404 responded:
I had a complete hysterectomy at 34 . I had an abnormal PAP
and my Dr. thought it best. I kept getting PAP's all these years ,now am 68. I thought why? I have no uterus or cervix. It seems that HPV can cause cancer of the vagina much to my surprise because I never knew I even had HPV. No symptoms at all. I get checked every 6 months to see if it remains very low grade and there is nothing to do unless it begins to get worse. I am told it's rare but it does happen. I really have no symptoms and have stayed the same for 3 or 4 years now.

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