Medical Q&As

Smear test - after hysterectomy?

Do you still need to have smear tests test after hysterectomy?

Hysterectomy involves the removal of the complete womb, which includes the cervix. In the past a small stump of the womb was occasionally left behind however this is no longer standard practice when performing a hysterectomy. In that particular scenario there would have been a justification for recommending periodic smear testing because the cervix was still present even though the bulk of the womb was gone. However, that is a slightly academic point because as previously stated it is the usual practice nowadays to remove the entire womb. The cervix is an integral part of the womb so once a hysterectomy has been performed there are no cervical cells remaining. Therefore there is no need to perform a smear test. There is one important exception to this rule and that concerns the woman who has undergone a hysterectomy for carcinoma of the cervix. In that particular case the woman is kept under surveillance after surgery in order to verify that there has been no local recurrence of the cancerous cells. This surveillance could include tissue sampling similar to smear testing and would also include colposcopy at appropriate intervals. It is important to appreciate that the primary purpose of smear testing is to obtain a sample of the particular cells that are located just at the opening of the cervix. In summary if the cervix has been removed those cells are gone and therefore there is no need for smear testing.