Question for an OBGYN to answer. HPV in a patient who has had a complete hysterectomy?

Question

My mom had a complete hsyterectomy 1 year ago. Recently, she went to the doctor for her annual pap smear. The test revealed some shocking results- the pap smear came up positive for high risk HPV. The lab techs who did the tests were shocked because, as you know HPV is an infection of the cervix. My question is, how can this be infecting her if she has a complete hysterectomy? The lab also stated that squamous intra-epithelial cells were detected. How can something like this be treated? Can someone give me an explanation. They are running more tests on her in the next upcoming weeks, but, being a pre med student I am very interested in how this can be. Thanks.

Answer 1

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Answer 2

Virtually all cervical cancers are due to a persistent progress high risk HPV types…..but not all hysterectomies are due to cervical cancer.   I am not sure why your mother had her hysterectomy.  Some women have a hysterectomy due to abnormal bleeding, endometriosis endometrial cancer, fibroids, ovarian cysts and 0varian cancers ...a longer list.  Was your mothers hysterectomy due to cervical cancer?

Did your mother have a round of radiation after her hysterectomy for cervical cancer?

A hysterectomy may remove the proplem cervix but the virus can also live on the vaginal walls or under the vaginal cuff that was made during her hysterectomy. The virus also affect the v***a, anal area and the anal canal.   After a hysterectomy where our cervix was removed the Pap smear is taken of the vaginal vault of the vaginal cuff…There can still be the virus on the vaginal cuff or on the vaginal wall resulting in a positive HPV test with squamous interpeiatheial cell changes.  

We can acquire HPV after our hysterectomy.  If you mother has had a new s*x partner this may be why these cell changes are showing.  The virus infects the vaginal walls.  Our Pap test never includes cells of the v***a.  

Sometimes in a rare case the cervical cancer may progress or it is called recurrent cervical cancer.   The local spread of cervical cancer may progress through the parametrium to involve the ureters and, eventually, the pelvic sidewalls. In some patients, the sciatic plexus is involved. Hydronephrosis, pyelonephritis, and renal failure are common complications of progressive disease. Involvement of the urinary bladder and r****m can occur in advanced cases because of direct tumor extension or subsequent to invasion of the vesicouterine or uterosacral ligaments, respectively. A vesicovaginal fistula or rectovaginal fistula may or may not develop. A tumor that extends through the posterior aspect of the cervix or corpus infrequently leads to intraperitoneal spread. Adnexal metastases are uncommon in the earlystages of the disease.

Lymphatic tumor spread usually occurs in a fairly orderly pattern or sequence that first involves the regional paracervical and parametrial lymph nodes and then the internal and external iliac lymph nodes. This may then be followed by spread to the common iliac nodes, the para-aortic nodes, and eventually the supraclavicular nodes via the thoracic duct. Metastasis to the para-aortic lymph nodes without involvement of pelvic lymph nodes is unusual.

These are the two links…

Patients with recurrent cervical cancer

http://www.emedicine.com/med/TOPIC3332.H...

This is great information:

Vaginal Colposcopy: Colposcopic Clues for the Identification of Benign and Malignant Disease

http://www.asccp.org/edu/practice/v****a...

I am sorry all this is happening to your Mom...

I am not a doctor but since my high risk HPV was diagnosis after a total hysterectomy...for non cervial issues...non of the samples taken at my hysterectomy showed any cancer....I  have done lots of reading...finding information for me.  

I have VaIN 2/3 and VIN 3 with one lesion CIS

I wish you and your mother well.

Answer 3

I’m sorry I know we are talking about your mom, but there is really nothing shocking about her results. Most people who are sexually active have been exposed to HPV.

HPV is NOT an infection of the cervix. It is a virus and like all viruses it is not limited to the cervix or any other part of the body. Therefore having a hysterectomy has nothing to do with having the virus.