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Vaginal Cuff Smear

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Christina S. Chu, MD
Last Modified: November 1, 2001

Dear OncoLink "Ask the Experts,"
In March of 2000, I had a hysterectomy, leaving only my ovaries in place. Just last week I had my yearly follow up visit and they did a pap smear. The doctor's office called and told me my pap smear had come back abnormal and wants to do another pap smear in three months. I have been told that unless the Pap smear was identified as being a smear of the vaginal cuff, rather than of the cervix, the results could come back as abnormal. If it was in fact identified as a vaginal cuff Pap smear, what does this mean?  
Thank you for your time.

Christina S. Chu, MD, Assistant Professor of the Division of Gynecologic Oncology at the University of Pennsylvania Health System, responds:

There are many different abnormalities that can be seen on a Pap smear, and most are minor problems. A Pap smear can be deemed an inadequate specimen because of excessive bleeding or inflammation. Technical problems such as drying artifact can also make a smear inadequate. Women who have a cervix are required to show two different types of cells on the Pap smear, representing both the inside and outside of the cervix, for the specimen to be adequate.

Even if your Pap smear was correctly identified as a vaginal smear, you may still have abnormal cells that require follow up with another test. Abnormalities can range from "atypical" cells, to changes associated with the human papilloma virus (HPV) or wart virus, to dysplastic (or precancerous) changes. Because there are so many different types of abnormalities, if you have further questions, you should discuss your specific diagnosis with your physician.