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HPV or cancer on vaginal cuff after hysterectomy?

Posted by kristindeann @kristindeann, 3 days ago

Hi, I am thinking about have a hysterectomy because I have persistent high risk HPV and a new recent positive dual stain test and my cervix is too stenotic for doctors to biopsy the transformation zone. I just read that HPV, CIN, and cancer can still be found on the vaginal cuff of women who had hysterectomy in order to prevent cervical cancer and that a colposcopy should be done of the vagina before hysterectomy to determine the margins needed during surgery. Has anyone experienced either HPV, pre-cancer, or cancer on the vaginal cuff after hysterectomy or had tests done before hysterectomy to rule out HPV caused oncogenic changes on the vaginal cuff and how you dealt with it? Thanks!

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Helen, Volunteer Mentor | @naturegirl5 | 2 days ago

@kristindeann I re-read your post from July 2025 and all you went through at that time. I cannot answer your questions about the pre-testing prior to a hysterectomy to get adequate margins.

I had a radical hysterectomy with removal of uterus, ovaries, fallopian tubes and cervix for endometrial cancer (endometroid adenocarcinoma, FIGO Grade 1, Stage 1a). I had a recurrence two years later that was found by physical exam on the vaginal cuff. The treatment for the recurrence was external and internal radiation therapy. The recurrence was 4 years ago and I've had no evidence of disease since then.

Your reasons for considering a hysterectomy are primarily preventive and this seems clear to me. Have you discussed this with your gynecologist? If yes, what did your physician say? Have you sought out a second opinion?

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cookercooker | @cookercooker | 1 day ago

I had a radical hysterectomy for serous cell endometrial cancer that had penetrated the myometrium almost all the way through. Inguinal lymph and para-aortic nodes were affected, and hence, my cancer was stage IIIC. Four months after the hysterectomy and 6 rounds of chemo, cancer was found in the vaginal cuff. I attribute this to the fact that the surgeon was unable to get clear margins, and thus left some cancer behind. I do not know if HPV was involved--no one mentioned it.
The cancer was detected by coloscopy, which was ordered because of suspicious cells in a pap smear. HPV could have been the cause, though. I had anal cancer 13 years ago and underwent chemo and radiation for it. No recurrence of that form. I have read that HPV can lead to anal cancer. But, my endometrial cancer could have been caused from the radiation I received on the anal tumor. No one has mentioned this either to me; it's just my assumption.
I am now on enhertu to deal with endometrial cancer. After a year of treatments every 3 weeks I am NED. Yet, I need to continue the treatment indefinitely, to prevent recurrence.
I'm not sure if I answered your question adequately, but hope it helps somewhat.

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