total hysterectomy..Mayo Clinic

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Are Pap tests still needed after removal of the uterus (hysterectomy)?Answers from Sandhya Pruthi, M.D.It depends.

A Pap test, also called a Pap smear, is a routine screening test for early diagnosis of cervical cancer.

If you had a partial hysterectomy — when the uterus is removed but the lower end of the uterus (cervix) remains — your health care provider will likely recommend continued Pap tests.

Similarly, 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 are still recommended as an early detection tool to monitor for a new cancer or precancerous change.

You can stop having Pap tests, however, if you had a total hysterectomy for a noncancerous condition.

Your age matters, too.

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

My sister thinks she does'nt ever have to be checked down there since her total hysterectomy after reading this I guess she's right since she did not have any precancer only fibroids. This stuff is so confusing 

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  • Posted

    Same with my mom, she stopped have pap smears after having a total hysterectomy at the age of 35.  What's so confusing? Have you had a hysterectormy?

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    • Posted

      no but my sister did..the confusing part is if you had hystrectomy because of precancer then even though you get total hysterectomy you still have to have pap smears but if you had total hystrectomy because of some other reason you don't...my point is both have total hysterctomy so why would one still needs pap smears and the other don't because with both they removed everything!

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    • Posted

      That is correct because of the predisposition to cancer cells reproducing if the removal was for a precancerous condition. This is why people who go into remission of their cancers are always getting checked that it doesn't come back and good enough reason to have pap smears done.

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  • Posted

    Crosado did your sisters fibroids give her bad symptoms?
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    • Posted

      YES! She bleed extermly heavy and her pain was unbareable, I mean she would be in bed for days and going through pads like crazy. Taken pain meds. She had some big ones. She opt for a complete hysterectomy instead of just having them removed. She has never regretted it, all though she had some rough times with the horrid symptoms of  getting through the shock of been thrown into surgical menopause the first couple of months. 
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    • Posted

      Wow. How big were her fibroids? Hopefully I won't get any symptoms. Brand new option now still cutting edge technology is focused ultrasound treatment.

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    • Posted

      I dont know but according to what her report said they where BIG! what is a "Focused ultrasound treament'?  Wonder why some womens fibriods don't bother than and some do?

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    • Posted

      Yeah I wonder why too. But I guess it's like how some sail through peri and others don't. My two largest are size of baseball and golfball.

      Focused ultrasound is where they use ultrasound to shrink/remove it and not cut. It's being used for essential tremors. They make a hole in the part of the brain associated with movement with the ultrasound. I just recently heard a talk at my dystonia support group. Can't explain more than that as it was a bit too advanced for me. Only Stanford and UCSF are doing it in California. Also some place in Toronto and Palermo Italy.

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    • Posted

      To me that sounds scary! They bore a hole in your head for the fiborids too?? I was told fibriods shrink in meno, not sure its true or not! YIKES!
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    • Posted

      No for fibroids it's not the brain. Well at least I don't think it is. He said they used it for fibroids so now there's that treatment option too but didn't say how or where they put the ultrasound. The talk was for movement disorder so he just mentioned the other uses and fibroids was one of them. Interesting thing is in the future they are going to start clinical test on Alzheimer's to see if it helps.

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    • Posted

      lol I know fibroids is NOT the brain BUT the hole in the head was only thing mentionED :-)  With all  this new technology I'm afraid we are all going to become guinea pigs! 

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    • Posted

      Lol sorry I worded it unclearly.

      And yes the doctor said they are still in talks with Medicare to cover it then in a year or two insurance companies may cover it.

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  • Posted

    As far as pap smears after hysterectomy - What you posted was my understanding.

    As far as fibroids - I've heard of focused ultrasound but don't know much about it except that I believe most insurance plans still consider it experimental. But the good thing is that it preserves the uterus and its life long / non-reproductive functions. Unfortunately, far too many women lose their uterus when they only need to lose the fibroids! I had a hysterectomy and its been BY FAR the worst thing that's ever happened to me!

    CCinCal - Hopefully, you can find a gyn or radiologist who will restore your body's functions instead of causing a whole new set of problems which is what happens when body parts are removed.

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    • Posted

      Hi what sort of problems did/do you have after the hysterectomy?

      My options are leaving it alone, taking just fibroids out, take out fibroids plus uterus or fibroids plus uterus plus ovaries.

      Only reason I am considering total is because of all the severe peri symptoms. But then I'm assuming all the peri symptoms will go away which I'm starting to discover is faulty, wishful thinking.

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    • Posted

      Based on my experience and knowledge, I'd have as little as possible removed provided this is a benign condition (almost all fibroids are benign).

      You think peri is bad, thankfully it's only temporary! Having ovaries removed (or their common failure after hysterectomy) puts you in a permanent state of hormone / endocrine havoc. With natural menopause, the body "settles in" and the ovaries continue producing hormones for decades (in their endocrine / non-reproductive role) especially testosterone that your body converts into estrogen on an as needed basis. These hormones are vital to every aspect of health and no HRT can adequately compensate for ovary removal or ovarian failure. Medical studies show that ovary removal (which would also be true for failure) is associated with accelerated aging / increased mortality in the way of heart disease, stroke, osteoporosis, dementia, Parkinsonism, memory and cognitive impairment, lung cancer, ocular changes, skin changes. Those are the ones I recall off the top of my head! Studies also show negative effects on mood, sleep and sexual function.

      The uterus also has life long functions. It's a place holder for the bladder and bowel which is why many women have bladder and bowel problems especially in the long-term. Studies show an increased risk of incontinence and prolapse.

      The uterus and cervix are key to a satisfying sex life for many women. (So are the ovaries.)

      The ligaments that hold the uterus in place are the pelvis' support structures. That's why women's figures gradually change after hysterectomy. The midsection compresses and thickens and their bellies protrude. They lose their waist which is a buffer between the rib cage and hips. This leads to chronic back, hip and midsection pain or discomfort.

      My organs were unnecessarily removed 10 years ago and it has negatively affected every aspect of my life. I was shocked that anyone could age so quickly! By 4 months post-op, I had lost so much hair, it became fine, dry, and frizzy and sections turned gray plus I lost a lot of skin collagen causing wrinkly and saggy skin causing me to look 15 years older. I became severely depressed, anxious, irritable, overwhelmed by everything, couldn't concentrate, couldn't remember anything (to the point of being scary), vision became blurry, couldn't sleep more than 2 or 3 hours at a time, body overheated easily, had zero energy or motivation, lost strong feelings of love for husband and children, lost all libido and sex was extremely disappointing. My bladder and bowel didn't work properly and bowel problems have never resolved. Bladder acts up occasionally. I have many close female relatives and none of them who are intact and have gone through natural menopause have had these problems. Their only complaints have been disrupted sleep and worse memory.

      I have been on HRT and although most hormonal symptoms have improved, I'm nowhere near the vibrant, happy, social and sexual person I was before the surgery. I still miss the closeness I felt with my husband and children as well as a libido and satisfying sex life. I'm never comfortable in social situations and lack the ability and interest to do all the things I used to. And my hair has never stopped falling out and is so dry, fine and frizzy! And the figure changes (that became apparent before the second year) along with the ever increasing back and hip discomfort have been just as distressing!

      It's quite shocking what happens even though it's a common surgery and presented as "benign" ...certainly not something to take lightly!

      What are your symptoms - heavy bleeding? Frequent urination? Pain? How big are your fibroids? Please advocate for yourself since you are the one who has to live with the consequences. Best of luck to you!

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    • Posted

      Hi age, I'm so sorry to hear of your horrible outcome with removing your ovary. Not everyone however, has the same experience. My mom had her ovaries removed, after discovering she had a lot of fibroids. As such she did not go through the horrible experience you're describing. She had hers removed when she was 35. When she turned 50, she went on HRT, because she was feeling hormonal fluctuations. She was on it for 3 years then stopped because she had had a triple bypass. Her hair did change a little but never fell out, her figure never left either and she never had back pain. She was always outgoing, bubbly and chic! But it's good you post your experience.

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    • Posted

      My mom passed away a few years ago at the age of 70. I'm in perimenopause albeit at my age I should be in menopause but the women in family continue to have periods into their 60's.

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    • Posted

      Wow - Your mom had heart disease at a young age (triple bypass at age 53) and died fairly young too. A lot of people don't know that hysterectomy is associated with an increased risk of heart disease. If ovaries are removed or fail that risk is even greater (5-7x that of an intact woman). And there are many more increased health risks of losing ovaries or their function as I previously noted. Some of them can take years to manifest such as heart disease (the #1 killer of women), osteoporosis, dementia, Parkinsonism. This is information that women should be given as part of the decision process. Another problem is that many women don't correlate their health problems to the loss of their organ(s) or they're embarrassed to talk about them especially the  bladder and bowel problems, sexual dysfunction, and altered figures.

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    • Posted

      Yes, that is true. However, once she had the triple bypass, she was well again. Fortunately, she didn't suffer from any other ailments. She died of a genetic lung issue she had been born with that I believe got triggered after spraying pesticides in her garden. She was dead within the year.

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    • Posted

      Dear aged too fast, thank you very much for being so open and sharing your experience and knowledge. I had no idea of all the negative conditions that can arise from a hysterectomy. My doctor never said a word! It didn't even occur to me about our uterus and ovaries being a placeholder but of course gravity! Wow lots to think about. I will definitely be researching more on it.

      May I ask why you had it done unnecessarily?

      My 2 largest fibroids are the size of a baseball and a golfball. I'm starting to have frequent urination and cramping. But mainly I was thinking it would eliminate my severe peri symptoms. I've been housebound for over a year now. But after reading your experience and having my gallbladder out (probably unnecessarily) a few months ago I'm also believing in keeping as many body parts as possible for as long as possible.

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    • Posted

      Ugh - I typed out a long reply and for some reason it didn't post!

      You're welcome. Unfortunately, so many women learn of the negative effects first hand - after they've had the surgery. Their gyns were not upfront with them.

      If anything, hysterectomy would worsen peri symptoms since removal of the uterus can impair ovarian function even to the point of complete failure. The ovaries in naturally menopausal / intact women produce hormones our whole lives - they merely switch from their reproductive (exocrine) mode to their menopausal (endocrine) mode. Ovary removal (which is oftentimes done at the time of hysterectomy) or ovarian failure (that happens frequently after hysterectomy) is a "surgical" type menopause aka "menopausal hell" or "menopause on steroids" ... certainly something to avoid!

      But even absent the hormonal effects, the anatomical, skeletal and sexual fall-out from hysterectomy are troubling enough.

      If you think you're close to menopause, maybe you can wait it out when the fibroids will shrink. If not, you may want to consider myomectomy to remove just the fibroids so you can keep your uterus and its life long functions. The reason hysterectomy is so prevalent is that it's easier / more profitable than myomectomy. Myomectomy takes more time and from what I've read insurance reimbursements aren't any better. Plus in the U.S., gyn residents are required to do a minimum number of hysterectomies but there's no requirement for myomectomies. I suspect that's why my organs were removed for a suspicious 9.5cm complex ovarian cyst despite the frozen section proving it was benign. Another financial incentive is that the da Vinci robots are expensive, both from a capital outlay and maintenance expense perspective. They have to keep using them to recoup all those costs.

      I wish you the best in getting proper treatment...treatment that restores your health versus causing a whole new set of problems.

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