Post total hysterectomy indications for pap smear

[DrMetal]

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I've often read that post total hysterectomy for a high grade cervical lesion may still require PAP smears for surveillance. Dumb question (forgive me, I'm a hospitalist): If the hysterectomy was total and considered definitive for treatment, what would you be 'smearing' when you do the PAP? There's no cervix anymore, not even remnants, right? Are you taking cytology from the proximal vaginal canal, just to ensure no spread?

 

[anonperson]

I've often read that post total hysterectomy for a high grade cervical lesion may still require PAP smears for surveillance. Dumb question (forgive me, I'm a hospitalist): If the hysterectomy was total and considered definitive for treatment, what would you be 'smearing' when you do the PAP? There's no cervix anymore, not even remnants, right? Are you taking cytology from the proximal vaginal canal, just to ensure no spread?

The vaginal cuff. Where the cervix used to be.

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[DrMetal]

The vaginal cuff. Where the cervix used to be.

Wow, now that's a place I've never been. Thanks!