WOMENS-HEALTH Messages for May, 1997: Re: pap after VH

Re: pap after VH

From: D. Ashley Hill, M.D. (anonymous@obgyn.net)
Mon, 19 May 1997 10:57:04 -0500 (CDT)

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At Mon, 19 May 1997, Judi wrote: >
>I just had a vaginal hysterectomy and have a few ?'s. My cervix was
>removed. Would I still need to have paps?

Judi-

There is a recent medical paper that suggests that women who have had hysterectomies for reasons *other* than abnormal Pap smears do not need to have Pap smears. However, this is new info, and many doctors are uncomfortable with this. As with all things in medicine, reading it once is usually not enough to make you change the way you practice. I predict, though, that managed care companies will quit paying for annual Pap smears in women who have had hysterectomies. One important point is that during an annual exam you should have much more than just a Pap smear. We routinely do breast exams, feel for ovarian tumors, do a rectal exam (particularly on women over age 40), check for vaginal infections, evaluate the bladder, and in many cases do a full physical, urine dipstick, and blood count. This is a lot of "tuning up" whether or not a Pap smear is done!

Also, doesn't total hysterectomy >mean that the uterus and cervix are removed? and partial is when the
>cervix remains?

Pretty much. The term Total Hysterectomy implies the uterus and cervix were removed, whereas the term Partial Hysterectomy implies only the uterus was removed. Most doctors use the term "Subtotal hysterectomy" when the cervix remains behind. However, patients almost always use "complete" to mean the ovaries were taken, and "partial" to mean they were not, but this is incorrect from a medical point of view.

Ashley

>Thank You
>
>--
>Judi
>

--
Ashley Hill
D. Ashley Hill, M.D.
Assistant Director, Department of Ob/Gyn
Florida Hospital Family Practice Residency
Orlando, FL
dahmd@gate.net

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