If a patient has previously undergone a hysterectomy, the cervix is usually no longer present and only a vaginal cuff remains. If the pathology was benign, then the patient no longer requires Pap smears (11). However, if the hysterectomy was performed for cervical cancer or dysplasia, cervical cancer screening on the vaginal cuff should continue since remnants of cervical tissue may be present. These women are also at higher risk for vaginal in- traepithelial neoplasia (VAIN) and vaginal cancer. If the hysterectomy was performed for benign causes, yet the patient has had documented HPV in- fection or multiple sexual partners, she is at slightly higher risk for vaginal cancer,.
