Welcome to

Gynaecology and Obstetrics Update

Your Questions Answered

Author

T M Malak

MB, BCh, M. Sc., DFFP, Ph.D., MRCOG, FRCOG

Consultant Obstetrician and Gynaecologist

Eastbourne District General Hospital

Address

Esperance House, Esperance Private Hospital

Hartington Place, Eastbourne, BN21 3BG

Tel

01323- 414805 / 410717 & 410929

Fax

01323- 730313

Q Vault smears. What do you think of nurses doing these?  Not much is said about them when we do updates on cervical cytology. Do you think gynaecologists should do them, as there is a risk of malignancy?  I am thinking that cancers of other sites are followed up by breast and bowel surgeons, etc

A Vaults smears can be done by trained nurses and doctors. The vaginal vault should be well visualised. Cells should be obtained from the whole vault especially the vault corners. Both cervical and vault smears are done for malignancy screening. There is no role for vaginal vault smears after hysterectomy for endometrial cancer. Vaults smears are required for patients who have hysterectomy and cervical pre-cancerous or cancerous lesions were diagnosed. According to the draft of the new guidelines for follow up in these conditions vault smears should be taken for 10 years

Q Some ladies who have had annual smears after laser/biopsy ,for 5 or 10 years , want to go on receiving annual smears ad infinitum.  Should they have any ongoing annual smears done privately ?  Do we have an actual policy on this?

A  According to the draft of the new guidelines for follow up after treatment of pre- cancerous cervical lesions smears should be taken for 10 years then 3 yearly until the age of 65, These guidelines will be followed by NHS providers.