Have you wondered if you really need a Pap test after a hysterectomy? Let me tell you my story and you decide.
I had my family physician tell me that I would never need another Pap test because I had my cervix removed when I had my hysterectomy May 23, 2002 and I had never had a bad Pap. I thought he must know what he was talking about, so I went for almost four years without a Pap test.
I switched doctors the beginning of 2005, and in May 2005, during my annual physical, she recommended that I go ahead and have a Pap. It came back with abnormal cells (ASC-US). It was thought at that time that I had a bacterial infection which was causing this result, so I was given an antibiotic and told to repeat the Pap in a month.
Well, due to my mom's illness and death, I didn't get the repeat Pap until August 2005. It again came back with a finding of ASC-US. My doctor requested an HPV test, which came back positive for one or more of the viral strain which causes cervical cancer.
(HPV is a very common sexually transmitted viral infection which can occur in 80% of all sexually active people at some time during their life. There are over 100 strains of the virus, some of which can cause genital warts, but others, like what I have, which cause cervical cancer. And the virus can lie dormant for years before causing problems.)
I was then sent to a specialist for a colposcopy, which came back with a finding of moderate to severe dysplasia on three different biopsied areas. Dysplasia is changes in the cells and severe dysplasia is the stage right before invasive cancer.
Usually the treatment for dysplasia is a hysterectomy, but I've already had one. Since I no longer have a cervix, laser vaporization surgery is usually necessary. However, my doctor feels that all the abnormal tissue was removed during my colposcopy and that my body has cleared itself of the HPV, so the laser surgery was unnecessary in my case.
My last Pap test and colposcopy in August of 2006 was normal. I still have to have repeat Pap tests every three months to be sure the abnormal cells do not return. Hopefully, I won't have any further problems, but there is always a chance of reoccurance, especially since the cell changes were caused by HPV, which can lie dormat for years.
If I had listened to my first doctor, I would never have had another Pap and the abnormal cells may have never have been caught in time. My life could have been in danger just because this doctor told me that I didn't need another Pap test ever again! Needless to say, I am now a firm believer in Paps after hysterectomy! (And will now be having one every three months for awhile.) My gyn told me since there is no clear dividing line between the cervical cells and the vagina, there are always some cells left, so that's why it is so important.
Please, do yourself a favor and get the Pap tests anyway. It's not that big of a deal to have done, but it could save your life.
My Pap test in December 2006 came back abnormal again, this time a level worse than ASCUS. A colposcopy in February diagnosed VAIN 3/CIS (carcinoma in situ - cancer which hasn't spread yet.) I'm currently scheduled for laser vaporization surgery on May 9 2007, which should take care of the problem once and for all. Let's hope so, anyway!