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All women between the ages of 18 and 70 years who have ever been sexually active should have a Pap test every two years. Women who have had a hysterectomy may believe they no longer need to have Pap tests. However, some women still need to be regularly screened, depending on the type of hysterectomy they had and the reasons for the surgery.
Hysterectomy explained
The uterus is a muscular organ of the female body, shaped like an inverted pear. The two attached fallopian tubes each open near an ovary. The cervix (neck of the womb) is located at the base of the uterus. This connects to the vagina. Hysterectomy is the surgical removal of the uterus and is used to treat a number of conditions, such as excessive menstrual bleeding, endometriosis, fibroids or prolapse. After a hysterectomy, a woman no longer menstruates and cannot become pregnant.
Types of hysterectomy
There are several types of hysterectomy, including:
- Partial hysterectomy – the bulk of the uterus is removed, but the lower end of the uterus, the ovaries, fallopian tubes and cervix remain.
- Total hysterectomy – the entire uterus and cervix are removed, but the ovaries and fallopian tubes remain.
- Total hysterectomy with salpingo-oophorectomy – the entire uterus, cervix and one or both ovaries and fallopian tubes are removed.
- Radical hysterectomy – the entire uterus, cervix, ovaries and fallopian tubes are removed, along with associated lymph nodes and the top-end of the vagina.
Pap tests are still important after some types of hysterectomy
Women will still need regular Pap tests or vaginal smears (where a cell sample is taken from the top of the vagina) if they:
- Still have a cervix (partial hysterectomy)
- Have had a hysterectomy as part of treatment for gynaecological cancer, such as cancer of the uterus
- Have ever had a significant abnormality detected on a Pap test
- Have never had a Pap test.
When Pap tests are no longer necessary
Some women who have had a hysterectomy don’t need to have any more Pap tests. This is the case when:
- The woman’s cervix was removed during the hysterectomy (total or radical hysterectomy)
- The operation was performed to treat non-cancerous conditions, such as endometriosis, uterine prolapse or menstrual problems
- Prior to the hysterectomy, the woman had regular Pap tests every two years and never had a significant abnormality detected.
Check if you are unsure
Some women aren’t sure what kind of hysterectomy they have had. The easiest way to check is to ask your doctor. If this isn’t possible, or if your doctor doesn’t have the information on file, there are various methods of investigation that can be used, including an internal examination and taking a cell sample. The cell sample is typically taken from the site where the vaginal tissues were sutured and is called a vaginal vault smear.
If you have no cervix and had the hysterectomy for reasons unrelated to cancer, and if the vaginal vault smear returns a normal result, you usually don’t require another Pap test.
Pap tests after hysterectomy for cervical cancer
Some women undergo hysterectomy as treatment for cervical cancer. Even if the cancer was totally removed during surgery, you need to continue having vaginal smears (usually every year) for as long as your gynaecologist tells you is necessary.
Where to get help
- Your doctor
- Your women’s health nurse
- Gynaecologist
- Family Planning Victoria Tel. (03) 9257 0100 www.fpv.org.au/
- The Cancer Council of Victoria Information and Support Line Tel. 13 11 20 www.cancervic.org.au
- PapScreen Victoria – for online advice and information
- Multilingual Cancer Information Line, Victoria – see the Cancer Council Victoria’s website for contact details
Things to remember
- Some women who have had a hysterectomy may mistakenly believe they no longer need to have Pap tests.
- Some women still need to have regular Pap tests, depending on the type of hysterectomy they have had and the reasons for the surgery.
- If you don’t know what kind of hysterectomy you have had, ask your doctor.
You might also be interested in:
Cervical cancer.
Hysterectomy.
Pap test abnormalities.
Pap tests after hysterectomy.
Pap tests and women with disabilities.
Pap tests explained.
Pap tests for all women.
Reproductive system.
Uterine cancer.
Want to know more?
Go to More information for support groups, related links and references.
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