title: [Are vaginal pap smear necessary after total hysterectomy for CIN3?].
abstract: The practice of vaginal smears after total hysterectomy should be discussed according to the indication for hysterectomy. We have thus performed a literature review using PubMed medical database with selection of articles presenting a practical interest for clinicians. The practice of vaginal smears after endometrial cancer can be abandoned, but in case of cervical cancer it improves the performance of clinical examination in the early follow-up (in the first 5 years of follow-up) especially in early diagnosis of subclinical recurrence. After this period, the interest of vaginal smears drop drastically and the follow-up is mainly clinical. When hysterectomy is proposed as part of cervical intraepithelial neoplasia (particularly when associated uterine lesions and cervical conization not accessible), the risk of vaginal recurrence of HPV-induced pathology fully justifies an annual monitoring (recurrences or virus-induced lesions are seen up to 25 years after surgery). Finally, after hysterectomy for benign uterine non-HPV-induced, there is no need to propose a systematic follow-up cytology.
authors.affiliation: Service de gynécologie, CHU Anne-de-Bretagne, 16, boulevard de Bulgarie, BP 90347, 35203 Rennes cedex 2, France.
authors.forename: F
authors.initials: F
authors.lastname: Nicolas
authors.forename: L
authors.initials: L
authors.lastname: Vandenbroucke
authors.forename: M C
authors.initials: MC
authors.lastname: Voltzenlogel
authors.forename: V
authors.initials: V
authors.lastname: Lavoué
authors.forename: S
authors.initials: S
authors.lastname: Henno
authors.forename: J
authors.initials: J
authors.lastname: Levêque
mesh_terms: D005260:Female; D006801:Humans; D007044:Hysterectomy; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000517:prevention & control; D065006:Papanicolaou Test; D027383:Papillomaviridae; D030361:Papillomavirus Infections; D014626:Vaginal Smears; D002578:Uterine Cervical Dysplasia / Q000601:surgery* / Q000821:virology