Do our Gynaecologists follow post-hysterectomy vaginal vault sampling
guidance from NHSCSP? In terms of Who? What? When?
Gynaecology department South Tees NHS Foundation Trust, James Cook University Hospital (JCUH), Middlesbrough, UK

Authors: Mohammed Nabhan, Aishwarya Kadrekar, Eberechi Caleb Eke, Helen M. Doran

Objective:
We retrospectively audited post-hysterectomy vaginal vault sampling practice and adherence to NHSCSP guidelines.

Method:
Patients who underwent a hysterectomy in JCUH, June 2022- Dec 2022, were identified from Histology IT database and cross referenced with the MCNS/CSAS IT databases.
- Total of 205 cases identified
- 5 excluded
We sub-analysed by groups derived from NHSCSP guidelines[1], by hysterectomy histopathological result and pre-operative cervical screening “smear” history.

Results:
200 patients; age range of 25–87 years; 14% showed CIN or cervical malignancy.
Those of screening age (140/200) were sub-analysed in Table 1, as summarised in Figures 1&2, regarding vaginal sampling at 6 months post-hysterectomy.

Conclusions:
- NHSCSP guideline aims at identifying hysterectomised women who are potentially at risk of developing vaginal cancer.
- “Responsibility for implementing follow-up policies for these women, rests with the treating Gynaecologist”1.
- It is noted that only 20% (n=7/53) of women had the required vaginal smear performed at 6 months post-op and only 40% (n=56/140) were correctly “ceased” from cervical screening.
- Gynaecology surgeons appear to be unaware or unclear about NHSCSP Guidance.
- We recommend that the NHSCSP guidance is simplified and cascaded to all RCOG members.

Reference [1] NHSCSP Guidelines updated Sep 2024