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I have had a hysterectomy. Do I need to carry on having smear tests?

There is no simple answer to this often asked question, as it depends upon the situation. The important issue is that the patient knows what type of hysterectomy she has had and the reason for the procedure.

During a smear test, cells are removed from the cervix (neck of the womb) and examined for changes that may lead to cancer later on. If a woman has had a TOTAL hysterectomy, the cervix will have been removed. If she has had a SUB-TOTAL hysterectomy the cervix will have been conserved.

Therefore, in the case of a sub- total hysterectomy, the woman should attend for regular smears. Very frequently, women who have had a total hysterectomy will not need to attend as they have no cervix.

However, and this is EXTREMELY IMPORTANT, if the hysterectomy was performed as a result of cancer or for any other reason if there were pre- cancerous changes or the suspicion of cancer, the woman will still need regular checks. In cases such as these, a procedure known as a vault smear is performed. It is the same procedure but as the woman has no cervix, cells are removed from the closed end of the vagina and the vaginal walls.

All women undergoing hysterectomy should ensure that they know exactly what type of surgery they are having and ask the Gynaecologist if ongoing smear tests are recommended. If you are unable to find this information out, see your Doctor or Practice Nurse.

Benign Prostate Enlargement


Benign prostate enlargement (BPE) is a condition that affects men particularly over 50 years of age.

What is the prostate gland?

The prostate is a small gland found only in men, located in the pelvis, between the penis and bladder. It's involved in the production of semen.

The prostate produces a thick, white fluid that's made into a thinner liquid by a protein called prostate-specific antigen (PSA). The liquid is then mixed with sperm, produced by the testicles, to create semen.

If the prostate becomes enlarged, it can place pressure on the bladder and urethra (the tube through which urine passes). This can affect how you pass urine and may cause:

  • difficulty starting urination
  • a frequent need to urinate
  • difficulty fully emptying the bladder

In some men, the symptoms are mild and don't require treatment. In others, the symptoms can be very troublesome and have a major impact on a person's quality of life.

What causes benign prostate enlargement?

The exact cause of prostate enlargement is unknown, but most experts agree that it's linked to hormonal changes that occur as a man gets older.

How is benign prostate enlargement diagnosed?

If your GP suspects that you have an enlarged prostate, you'll be asked to complete a questionnaire to assess your symptoms.

Your GP will also want to rule out other conditions that cause similar symptoms to prostate enlargement. 

You may have a number of standard tests, such as urine tests, plus some more specific tests, such as a blood test that measures PSA.

Treating benign prostate enlargement

Treatment for an enlarged prostate is determined by the severity of your symptoms.

If you have mild to moderate symptoms, you won't receive any immediate medical treatment, but you'll have regular check-ups to carefully monitor your prostate.

You'll probably also be advised to make lifestyle changes, such as limiting your caffeine and alcohol intake, and exercising regularly, to see if they improve your symptoms.

As well as lifestyle changes, for moderate to severe cases medication can be used which block the effects of a hormone called dihydrotestosterone on the prostate gland which can reduce the size and relieve symptoms. Other types of medication that relax the muscles of the bladder making it easier to pass urine may be used.

Surgery is usually only recommended for moderate to severe symptoms of benign prostate enlargement that have failed to respond to medication.

Complications of benign prostate enlargement

Benign prostate enlargement can sometimes lead to complications such as a urinary tract infection  or acute urinary retention. Serious complications are rare.

Cervical Smear

Most women wait anxiously to hear the result of their cervical smear test and in most cases will be told that the result is negative/normal and advised when to have the next test performed.

This however is not always the case and it is natural for women to worry if they are asked to see their Doctor regarding the result or told that the test needs to be repeated.

In the majority of cases there is no need for concern and being armed with a basic understanding of the meaning of smear test results and terminology, unnecessary stress can be eliminated!

If you are asked to have the test repeated, do not panic! The main reason for this is that the Pathologist is unable to ‘read’ your result.

There are several reasons for this including:

An insufficient number of cells in the sample

Current or recent infection which means the cells could not be seen clearly enough

Blood in the sample which can make it difficult to see the cells clearly

An inflamed cervix, which also makes it difficult to see the cells

If you are asked to return for a repeat smear, you will normally be asked to do so after around 3 months. This allows time for new cells to grow having been removed during your previous test. Depending on the reason for needing a repeat test, you may be asked to use a treatment such as antibiotics, antifungals or in the case of older women, hormone treatments.

There are several ways in which smear test findings are reported depending upon the laboratory used. However, in general, there are three main categories for abnormal results, these are:

- Mild cell changes

  (also referred to as CIN I or mild dyskariosis)

- Moderate cell changes  

  (also referred to as CIN II or moderate dyskariosis)

- Severe cell changes (also referred to as CIN III or severe dyskariosis)

None of these mean that you have cancer!Your Doctor will want you to have further checks and possibly treatment to prevent cervical cancer which when confined to the cervix, is known as ‘carcinoma in situ’

You may also hear terms such as reactive changes, ASC, ASC-US. LSIL, HSIL. These are simply different names for non-cancerous or pre-cancerous changes.

If you are confused or concerned about your smear test result, speak to your family Doctor or Practice Nurse.

The Core Team

Dawn Blythe

Clinic Director, Practice Midwife

Yvonne Evans

Clinic Director, Nurse

Dr. An Croonenborghs

General Practitioner

Jane Evans