YourCarolina.tv

I have a question for the GYN doctor if you can get this to him.  I tried finding you when he was on the show but I was searching on Scene on 7 instead of Your Carolina, LOL. Anyway, I had a partial hysterectomy greater than 12 years ago and was told that I didn’t need to have a Pap smear anymore.  I have had one abnormal ultrasound of my ovaries with having a septated cyst which was repeated 3 months later and found to be normal. Do I need to have any further Pap smears and how often should I be having my ovaries checked as I know that ovarian cancer is of a concern in women and should there be a concern of any other cancer with having had a hysterectomy.

My name is Karen Potter and I work in the Public Relations Department at Greenville Hospital System. Dr. Wiper asked me to post the following response to Brenda Edwards question.

There are two issues here:

1. The need for pap smears after a hysterectomy

2. Evaluation of ovarian cysts

These two things are unrelated.

Women who have had a hysterectomy—which also included removing the cervix (i.e. not a “supracervical hysterectomy”)- may indeed be ok to not have future Pap smears.  But being told there is no need for future Paps depends on a couple things:

1. Multiple prior Paps being normal before the hysterectomy

2. Preferably, no history of HPV

3. The cervix which was submitted to the pathology department for evaluation at the time of the hysterectomy must also have been normal at that time.

Ovarian cysts are common and if this patient is premenopausal it is VERY common to get cysts and see them disappear.  It sounds like that is what happened.  Doing future Pap tests does not check on the ovaries, it only checks on the tissue touched by the Pap smear swab—the cervix or, in the case of a women having had a hysterectomy, the vaginal tissue.  This patient has concerns about ovarian cancer and she should get an annual pelvic exam—including a rectal/recto-vaginal exam.  This needs to be done whether she also gets a Pap or not.