Hysterectomy ~ Information for Women

Are Pap smears necessary after hysterectomy?

A hysterectomy is an operation to remove the uterus (womb). Hysterectomies may be performed because of abnormal or heavy bleeding, prolapse, fibroids or other gynaecological problems including cancer. In most cases, the whole uterus including the cervix is removed. Occasionally, a sub-total hysterectomy is done and the cervix is not removed. Sometimes the fallopian tubes and ovaries are also removed at the same time as the hysterectomy.

A Pap smear is a simple test to detect changes in the cells of the cervix (neck of the womb). Cells are taken from the cervix and fixed on a glass slide and sent to a laboratory for testing. The Pap test is a test to pick up abnormal cells so that these cells can be assessed and treated to prevent them later becoming cancerous.

Whether you need to have Pap smears after a hysterectomy depends on:

• Whether you still have a cervix
• Why the hysterectomy was performed
• Whether your Pap smears were normal before the operation

If you have a cervix you still need to have regular Pap smears

After a hysterectomy (if the cervix was removed), you may need to have a smear from the vault (top of the vagina), if:

• The hysterectomy was done because of cancer of the cervix, uterus, ovaries, or fallopian tubes
• Abnormal cells were found at the time of the surgery
• You previously had a high grade abnormal smear
• You have had abnormal cells in the vagina
• You don’t know whether you have ever had an abnormal smear or you don’t know why the hysterectomy was done
• You are taking medication which suppresses your immune system (eg cortisone prescribed for asthma or arthritis or medication for transplants)
• You were exposed to the drug diethylstilboestrol before you were born (this drug was prescribed to pregnant women to prevent miscarriage in the 1950’s and 1960’s)
• You have any pain, bleeding or abnormal discharge from the vagina

Most women who have had a hysterectomy do not need regular smears. If you are not sure whether you need a smear, talk to your doctor.

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