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Hysterectomy (cont.)

What are the alternatives to a hysterectomy?

As mentioned above, a hysterectomy for conditions other than cancer is generally not considered until after other tests or medications are unsuccessful. There are also newer procedures, such as uterine artery embolization (UAE) or surgical removal of a portion of the uterus (myomectomy), that are being used to treat excessive uterine bleeding. Endometrial ablation technique and newer medications are also alternatives.

Should women who have had a hysterectomy continue to have Pap smears?

Any woman with a history of abnormal Pap smears is recommended to have Pap smears for the remainder of her life. When the cervix has already been removed, these smears are more accurately called "vaginal cuff" smears, instead of Pap smears. This is because of the low, but real chance that cervical cancer can recur right at the surgical site where the cervix was removed.

In addition to women with a history of abnormal Pap smears, other women who require continued Pap smears are women with supracervical hysterectomy, in which the cervix was left in place. In this case, in contrast to the woman who has had hysterectomy for reasons of cervical cancer, the woman who has had supracervical hysterectomy will be able to follow the same screening guidelines as for other woman who have not had surgery. For example, the physician can stop doing Pap smears at age 65 if the woman has been well-screened and has always had normal Pap smears.

Women who do not need to continue having Pap smears are those who have had vaginal hysterectomy or abdominal hysterectomy for benign (not cancer) reasons, such as uterine fibroids. Provided that they have had normal Pap smears prior to the procedure, they need not continue to have Pap smears after their surgery.

Previous contributing medical author and editor: Medical Author: Carolyn Janet Crandall, M.D.
Medical Editor: William C. Shiel Jr., MD, FACP, FACR


Last Editorial Review: 8/10/2007


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Suggested Reading by Our Doctors
MedicineNet Doctors
  • Pap Smear - Read about Pap smear, a test to screen for cervical cancer, and precancerous changes in the cervix. Risk factors for abnormal Pap include HPV, smoking medicaitons, and a weakened immune system.
  • Ovarian Cancer - Get information on ovarian cancer symptoms, diagnosis, tests, staging, research, surgery and risk factors. Treatment options include surgery, chemotherapy and radiation.
  • Endometrial Ablation - Read about endometrial ablation, a procedure performed to treat abnormal bleeding of the uterus. During the procedure the lining tissues of the uterus are destroyed.

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