Pap Smear After Hysterectomy: Is it Necessary?

What is a Pap Smear Test and Why is it Done?

Pap Smear is an examination conducted on females to look at the status of the cervix. This test involves scraping some cells from the cervix area and then sending them to the laboratory for analysis to look for any abnormalities in the cervical region. Pap smear is used basically as a screening method for ruling in or ruling out cervical cancer in females. Pap smear test is necessary to be done normally in all females who are above 30 years of age at regular intervals along with screening for HPV virus which is common virus transmitted through sexual contact which is said to be in many ways responsible for causing cervical cancer in females.

Females who are believed to be at a higher risk for cervical cancer need to take this test more diligently. Pap Smear is also necessary for females who have undergone a surgical procedure to remove the uterus which is called Hysterectomy. Hysterectomy is basically done in two ways, one is partial hysterectomy and the other is complete hysterectomy. Partial hysterectomy signifies removal of the uterus but the cervix is left intact. Complete hysterectomy signifies complete removal of both the cervix as well as the uterus. It can be said that females who have undergone complete hysterectomy need not undergo pap smear test as there is no cervix and the risk of cancer is eliminated but this is not the case and the reason behind it is described below.

What is a Pap Smear Test and Why is it Done?

Pap Smear After Hysterectomy: Is it Necessary?

Some of the reasons as to why it is necessary to undergo Pap Smear Test after Hysterectomy are:

Pap Smear after Partial Hysterectomy: As stated above, in partial hysterectomy only the uterus is removed and the cervix is left intact which means that there is still risk for cervical cancer and other infections. Hence it is necessary for women who have undergone partial Hysterectomy to take Pap Smear Test after Hysterectomy in order to rule out any chances of infection or cervical cancer.

Females with Uterine Cancer: Females who have undergone Hysterectomy due to conditions like uterine cancer also need to have regular Pap Smears after Hysterectomy so as to check whether the cancer has spread to the cervix or not.

History of Abnormal Pap Smear: Females who have a history of abnormal pap smears in the past and have undergone hysterectomy also need to undergo Pap Smear after Hysterectomy as their chances of getting an infection or cervical cancer is much more than the normal population.

Females Exposed to Diethylstilbestrol: Females who have a history of being exposed to Diethylstilbestrol drugs in utero have a greater chances of getting cervical and other related cancers and hence it is necessary for them to undergo Pap Smear after Hysterectomy to rule out any such conditions.

Females with Compromised Immune System: A female with a compromised immune system is prone to get frequent infections and is at risk for developing serious conditions like cervical cancer and hence it is necessary that such females undergo Pap Smear after Hysterectomy to monitor the condition. This usually happens to females who have had an organ transplant or are suffering from HIV/AIDS.

When is a Pap Smear After Hysterectomy Said to be Abnormal?

A Pap Smear Test after Hysterectomy is said to be abnormal if any malignant cells are identified around the region of the uterus and cervix. These cells gradually spread to the vaginal vault cells complicating the picture. If a female has an abnormal Pap Smear after Hysterectomy then the physician will consider getting a biopsy of the vaginal walls and a treatment plan will be formulated based on the results of the biopsy. If changes are observed in the epithelial cells around the vaginal wall then destruction of the vaginal tissues will be recommended to control the development of abnormal cells.

What is the Procedure for Pap Smear Collection?

Pap Smear is quite a simple test which offers little to no discomfort for the patient. During the test, the patient is made to lie down in a lithotomy position. The physician then inserts a speculum through the vagina and observes the cervical region. The physician will then collect sample cervical mucus and scrapings for further analysis in order to rule in or rule out cervical cancer or other abnormalities.

In summary, it is necessary for females to have regular Pap Smear once they cross the age of 30. If a female undergoes hysterectomy whether it be partial or total even then it is important to get Pap Smear so as to closely monitor the function of the pelvic organs and in case of any abnormality a treatment plan needs to be formulated for treatment of the abnormality found on Pap Smear after Hysterectomy.

Pramod Kerkar, M.D., FFARCSI, DA
Pramod Kerkar, M.D., FFARCSI, DA
Written, Edited or Reviewed By: Pramod Kerkar, M.D., FFARCSI, DA Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:May 25, 2017

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