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Do you really need a pelvic exam after a hysterectomy?

After a hysterectomy, many women often wonder if they really need to continue visiting their gynecologists for yearly exams. Women should continue to see their OB-GYN after having part or all of their uterus removed. Depending on the reason for the hysterectomy, a woman may still need pelvic exams and cervical cancer screenings. Skipping a gynecological exam may mean skipping important health screenings and preventative care.

Is ovarian cancer still a risk after a complete hysterectomy?

While some women may think that a total hysterectomy where the ovaries are removed eliminates the risk of ovarian cancer, that’s not the case, but it reduces the risk dramatically. There is a 5 to 15 percent chance of cancerous ovarian cells left behind. Some ovarian cells don’t get removed during a hysterectomy because they travel to the perineum, the area between the vagina and the anus. While the ovaries aren’t present and infected, this is still considered ovarian cancer and is treated the same way.

Do you still need a Pap smear after a hysterectomy?

The sole purpose of a Pap smear is to screen for cervical cancer, so the only reason you need a Pap test is for this screening. If you had a full hysterectomy, in which your entire uterus was removed and your cervix was also removed, you might not need a Pap smear. If you had a partial hysterectomy and preserved the cervix, you should continue to have Pap tests.

However, if you had a partial hysterectomy or a total hysterectomy — when both the uterus and cervix are removed for a cancerous or precancerous condition, regular Pap tests may still be recommended as an early detection tool to monitor for any new cancers or precancerous changes.

In addition, if your mother took the drug diethylstilbestrol (DES) while pregnant with you, regular Pap tests are recommended, since DES exposure increases the risk of developing cervical cancer.

If you’re unsure whether you still need Pap tests, discuss with your gynecologist what’s best for you.

Bottom line

According to Michael Leung, MD, FACOG, a board-certified OB-GYN specialist at Houston’s Kelsey-Seybold Clinic, regular well-woman exams should remain a vital part of a woman’s overall health routine even after a hysterectomy. “Yes, you should continue seeing your gynecologist for an annual well-woman exam, which allows a doctor to screen for infections and evidence of cancers. “Continuing with your annual well-woman exam is a responsible way to care for your health after menopause or a hysterectomy,” says Dr. Leung.

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