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Normally, following a total hysterectomy, there are no
glandular cells to be found in the vagina. Endometrial cells will have
been removed, and the glandular cells lining the endocervical canal will
likewise be removed with the cervix. If the Pap smear
identifies glandular cells following a hysterectomy, it suggests that at
least some fragment of the cervix remains at the vaginal vault,
metaplastic change has occured along the incision line of the vagina, or
glandular cells have seeded to the upper vagina. In any event, these
patients should be considered to still have some cervical tissue and
regular Pap smears performed, as though they had not undergone a
hysterectomy. |