Is a Pelvic Examination Necessary After a Hysterectomy?

Question:

I had a hysterectomy in 2012. One doctor told me I would only need a pelvic exam every 3-5 years, while another doctor said that I still need yearly pelvic exams. Is there a lower risk of ovarian cancer after a hysterectomy?

Answer:

After having a hysterectomy, women often wonder if a pelvic examination is still required. This depends on the type of hysterectomy a woman has undergone, which determines which reproductive organs were removed. In various types of hysterectomies performed, the ovaries and fallopian tubes can be kept in place. In a partial hysterectomy, only the uterus is removed. Total hysterectomies remove the uterus and cervix while a radical hysterectomy goes even further and removes tissue on both sides of the cervix and the upper part of the vagina. Even though the ovaries are still intact, these hysterectomies can reduce ovarian cancer risk by a third. The type of hysterectomy where ovaries and fallopian tubes are removed is called a total hysterectomy with salpingo-oophorectomy.

While some may think that this eliminates the risk of ovarian cancer, that’s not the case – but it does reduce the risk dramatically. There is a 5 to 15 percent chance that ovarian cells left behind can become cancerous. Some ovarian cells don’t get removed during a hysterectomy because the cells travel to the perineum, the area between the vagina and anus. While the ovaries aren’t present and infected, this is still considered ovarian cancer and is treated the same way.

The NWHN agrees with the U.S. Preventative Services Task Force that there is currently no evidence that proves pelvic examinations done more frequently than three to five years are more beneficial. However, sufficient evidence that there is any significant harm in screening more frequently is also lacking. The general recommendation is that asymptomatic, non-pregnant adult women should receive an examination every three to five years, even after hysterectomies. For women who have a genetic risk of ovarian cancer or had a hysterectomy performed as a cancer treatment, a doctor would be more likely to recommend an annual checkup. Of course, you should always follow-up with your healthcare provider or seek a second opinion.

For more information on the risk of ovarian cancer after a hysterectomy, you can visit the following:

Our Bodies Ourselves

Healthline

American Cancer Society

For more information on pelvic examinations visit here.


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