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Research ArticleOriginal Article

Routine Vaginal Cuff Smear Testing in Post-Hysterectomy Patients With Benign Uterine Conditions: When Is It Indicated?

Andrea Videlefsky, Norman Grossl, Maxine Denniston, Rajneesh Sehgal, J. Michael Lane and Gerald Goodenough
The Journal of the American Board of Family Practice July 2000, 13 (4) 233-238; DOI: https://doi.org/10.3122/15572625-13-4-233
Andrea Videlefsky
From the Department of Family and Preventive Medicine (AV, JML) and the Department of Pathology and Laboratory Medicine (NG, RS), Emory University School of Medicine, and the Department of Anatomic Pathology and Cytology (NG), Grady Memorial Hospital, Atlanta; the Senior Health Center, St. Marks Hospital (GG), Salt Lake City; and the American Cancer Society (MD), Atlanta.
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Norman Grossl
From the Department of Family and Preventive Medicine (AV, JML) and the Department of Pathology and Laboratory Medicine (NG, RS), Emory University School of Medicine, and the Department of Anatomic Pathology and Cytology (NG), Grady Memorial Hospital, Atlanta; the Senior Health Center, St. Marks Hospital (GG), Salt Lake City; and the American Cancer Society (MD), Atlanta.
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Maxine Denniston
From the Department of Family and Preventive Medicine (AV, JML) and the Department of Pathology and Laboratory Medicine (NG, RS), Emory University School of Medicine, and the Department of Anatomic Pathology and Cytology (NG), Grady Memorial Hospital, Atlanta; the Senior Health Center, St. Marks Hospital (GG), Salt Lake City; and the American Cancer Society (MD), Atlanta.
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Rajneesh Sehgal
From the Department of Family and Preventive Medicine (AV, JML) and the Department of Pathology and Laboratory Medicine (NG, RS), Emory University School of Medicine, and the Department of Anatomic Pathology and Cytology (NG), Grady Memorial Hospital, Atlanta; the Senior Health Center, St. Marks Hospital (GG), Salt Lake City; and the American Cancer Society (MD), Atlanta.
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J. Michael Lane
From the Department of Family and Preventive Medicine (AV, JML) and the Department of Pathology and Laboratory Medicine (NG, RS), Emory University School of Medicine, and the Department of Anatomic Pathology and Cytology (NG), Grady Memorial Hospital, Atlanta; the Senior Health Center, St. Marks Hospital (GG), Salt Lake City; and the American Cancer Society (MD), Atlanta.
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Gerald Goodenough
From the Department of Family and Preventive Medicine (AV, JML) and the Department of Pathology and Laboratory Medicine (NG, RS), Emory University School of Medicine, and the Department of Anatomic Pathology and Cytology (NG), Grady Memorial Hospital, Atlanta; the Senior Health Center, St. Marks Hospital (GG), Salt Lake City; and the American Cancer Society (MD), Atlanta.
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Abstract

Background: By the age of 60 years, an estimated 33% of women will have undergone a hysterectomy. Approximately 85% of these hysterectomies are performed for benign disease. The object of this study was to evaluate cytologic findings from vaginal cuff smears in patients who have undergone hysterectomy for benign uterine conditions.

Methods: We conducted a community-based retrospective study and foilow-up of women with vaginal cuff cytologic smears who had had a hysterectomy for benign uterine conditions. A total of 220 women were randomly selected who had one or more vaginal cuff smears. The main outcomes measures were invasive carcinoma, dysplastic lesions, and infections detected by vaginal cuff smear testing. The setting was a large inner-city hospital.

Results: Ninety-seven percent of 220 women who underwent hysterectomy for benign uterine conditions and who were observed for an average of 89 months had no cytologic abnormalities on vaginal cuff smears. Cytologic evaluation found no invasive carcinomas. Dysplastic lesions were detected in 7 patients (3%). Seventy percent of patients (n = 154) had one or more infections; these infections included bacterial vaginosis (106), trichomoniasis (95), candidiasis (40), koilocytosis suggestive of human papilloma virus (HPV) infection (3), and cytopathic effect of herpes (4). The prevalence of koilocytosis was much higher in the patients with dysplasia (P = .0003).

Conclusions: Most routine vaginal cuff cytology screening tests need not be performed in women who have had a hysterectomy for benign uterine conditions.

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The Journal of the American Board of Family     Practice: 13 (4)
The Journal of the American Board of Family Practice
Vol. 13, Issue 4
1 Jul 2000
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Routine Vaginal Cuff Smear Testing in Post-Hysterectomy Patients With Benign Uterine Conditions: When Is It Indicated?
Andrea Videlefsky, Norman Grossl, Maxine Denniston, Rajneesh Sehgal, J. Michael Lane, Gerald Goodenough
The Journal of the American Board of Family Practice Jul 2000, 13 (4) 233-238; DOI: 10.3122/15572625-13-4-233

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Routine Vaginal Cuff Smear Testing in Post-Hysterectomy Patients With Benign Uterine Conditions: When Is It Indicated?
Andrea Videlefsky, Norman Grossl, Maxine Denniston, Rajneesh Sehgal, J. Michael Lane, Gerald Goodenough
The Journal of the American Board of Family Practice Jul 2000, 13 (4) 233-238; DOI: 10.3122/15572625-13-4-233
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