If a subtotal hysterectomy has been performed (only the corpus of the uterus has been removed but the cervix has been left in place) Pap tests are definitely necessary.
If the hysterectomy was performed because of malignancy, follow-up with Pap tests is required due to the possibility of lesions occurring in the vagina. The same applies for cases with a past history of premalignant lesions in the uterine cervix (CIN) or in any case where a hysterectomy was performed for other reasons (e.g. fibroids, haemorrhage, endometriosis), but HPV lesions were found on the cervix during at pathology.
Cytological examination of the vagina is not recommended only in those cases where a total hysterectomy has been performed for benign conditions and there was no history of HPV lesions.
