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Published on: September 12, 2025
859
Hysterectomy for abnormal cervical smear when local excision is not possible
Ka Wang Cheung1, Vincent Y T Cheung
1Department of Obstetrics and Gynaecology, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China.
Journal of Lower Genital Tract Disease
|November 26, 2013
Summary
Hysterectomy for abnormal cervical smears is effective but may require further treatment. Post-hysterectomy, persistent cytologic abnormalities and vaginal intraepithelial neoplasia (VAIN) can occur, with no clear predictors identified.
Area of Science:
- Gynecology
- Oncology
- Surgical Pathology
Background:
- Abnormal cervical smears often necessitate treatment, with hysterectomy considered when local excision is not feasible.
- Cervical neoplasia management requires careful consideration of patient factors and potential long-term outcomes.
Purpose of the Study:
- To evaluate the outcomes of women undergoing hysterectomy for cervical neoplasia where local excision was technically impossible.
- To identify risk factors and predict the occurrence of persistent cytologic abnormalities and vaginal intraepithelial neoplasia (VAIN) post-hysterectomy.
Main Methods:
- A retrospective chart review of women who underwent hysterectomy for cervical neoplasia between January 2000 and June 2012.
- Analysis of patient demographics, pre-operative findings, hysterectomy details, and post-operative follow-up data.
Main Results:
- Fifty-six women were included; 3.6% had cervical carcinoma requiring adjuvant treatment.
- Post-hysterectomy, 35.7% experienced persistent cytologic abnormalities, and 19.6% developed vaginal intraepithelial neoplasia (VAIN).
- Factors like age, surgical route, or prior procedures did not predict subsequent VAIN.
Conclusions:
- Hysterectomy is a viable management option for selected cases of cervical neoplasia.
- Further surgical intervention or adjuvant therapy may be necessary post-hysterectomy.
- Women should be informed about the risk of persistent cytologic abnormalities and VAIN, as predictive factors remain elusive.
