Pap Tests After a Hysterectomy: Are They Needed?
What Can A Pap Find After A Hysterectomy?
The overwhelming reason Paps are done is to detect cervical cancer. Since post-hysterectomy women don't have a cervix, this reason is gone. They can incidentally detect signs of infection -- both vaginal and sexually transmitted. But, most women are past the age range where these are major risks for her.
A sample of the vaginal wall is also taken during a Pap, and this is what continues after the hysterectomy. Mostly it is evaluated for the general appearance against the norms for women with her same age and history. Sometimes, this triggers an evaluation of the woman's hormones. But again, this is very rare and it is unlikely that if this test were abnormal that she wouldn't be complaining of other symptoms as well. Vaginal cancer can also be detected. But this is very uncommon, it isn't screened for in its own right, only because it is easy and inexpensive given the cervical sample is already being collected and read. Women who had hysterectomies for cancer may have more of a reason for taking the vaginal smear they are at higher risk.
Passing On The Pap Is Not The Same As Skipping The Annual
Still, don't confuse Pap with a pelvic exam--these are two different procedures. Again, the woman's reason for hysterectomy especially cancer may be valid reasons to continue the bi-manual (putting fingers in the vagina and pressing on the abdomen), and inspection of the external genitals. Information about remaining ovaries, pelvic relaxation (bladder positioning especially), vaginal dryness and atrophy, recurring tumors can be gained. Also, many gynys do a rectal/vaginal exam to check for masses in either or in between. The stool is tested for hidden blood at this time and provides another common screening for over 50 women. Lastly, the annual pelvic is often when the mammogram is scheduled and an in office exam of the breasts takes place.
To Pap Or Not?
Whatever a woman and her doctor decide, the pelvic/and pap are not an annual or not at all thing. Pelvic can be done alone. And intervals of 2-5 years of one or both can be scheduled depending on the woman's risk factors.