Are Pap tests necessary after a hysterectomy?

DEAR DR. GOTT: I had ovarian cancer and had a complete hysterectomy two years ago. My cancer was in the first stage, and, thankfully, I did not need chemo or radiation.

My surgeon continues to schedule me for Pap smears/internal exams yearly and says I will need to have this done for the rest of my life, but I don’t understand why. When I ask him, he gets short with me and says to “look it up on the Internet.” This does not make sense to me. Even my family doctor was surprised that I must continue to have Pap smears after having a complete hysterectomy.

Can you shed some light on this? Thank you.
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Daily Column

DEAR DR. GOTT:
I have a problem which no doctor seems to think is serious but I am very worried.

I had a complete hysterectomy when I was 28 because of cancer. I was lucky it was caught early. I am 65 years old.

About six years ago I started to “spot”. It is like a light menstrual period. I have seen three gynecologists who all say it is “normal”. I wear panty liners every day because I never know when it is going to start. Since I don’t have a uterus anymore, why am I bleeding?

DEAR READER:
Vaginal bleeding in a post-menopausal, post-hysterectomy woman is never normal. This is not to say that the cause of your bleeding is necessarily serious, however.

A complete hysterectomy is a surgery that removes both the uterus and cervix. The ovaries and fallopian tubes remain intact.

Without knowing more, I cannot guess what is causing the bleeding. Do you have pain just prior to or associated with the onset of the bleeding? Have you had a pelvic exam? Have you had any testing? These are all important questions that need to be answered (and followed up on, if appropriate).

The cause of your bleeding needs to be discovered. I urge you to find a gynecologist who will listen to your concerns and order appropriate testing. Perhaps you will have better luck beginning with your primary care physician. He or she can listen to your concerns and symptoms and then direct you to a resource for appropriate help. If your local gynecologists refuse to take the appropriate steps, asking your PCP to speak with them directly. This may yield favorable results, testing and a diagnosis. If not, consider a different gynecological group outside your local area, a teaching hospital or a specialized clinic, such as is available at Mayo Clinic or the Cleveland Clinic.

Your bleeding may be perfectly harmless, but given your history of cancer, you need to know definitively. Let me know how this turns out.