Vault smears

Hi all,

Just wanted to get some information about who is actually getting vault smears? It seems most people are having them after a radical hysterectomy but my area doesn't do them.
It just doesn't seem good enough to me, how can a 'visual' inspection and a quick feel be adequate when we all know any abnormalities start off as microscopic. Also in my case my cancer was missed several times, so I want thorough check ups.
I've discussed it with my CNS and she was having a word with my consultant about it who in turn has said she will discuss my concerns at my next appointment in May. I want to go in armed with information, so anything you can give me would be helpful! 

Hi there,

I don't get a vault smear either. I'm on 3 month check ups but it just involves a quick visual inspection and a manual inspection.

I asked last time why I am not given a vault smear and the consultant said they don't do them and that was that. I asked about scans also, but again they just said the statistics showed it didn't make any difference. The trust I'm in just seem to leave it unless you are bleeding or have any other symptom. I'm always wary that I had an MRI and an untrasound which didn't pick up my how can a quick look and feel pikc up anything untoward? And what about the rest of your body?

I did put a bit of a complaint in about it but just got told that they'd looked in to my complaint and it didn't change anything.

Good luck with taking it further!



Hi jo, im same they dont do any follow up scans or vault smears. I was told to watch out for any abnormal bleeding basically thats it. It leaves me feeling a little apprehensive tbh. Ive got my first 3 month check on mon and am crapping myself dont no what to expect. Lea xx

Hi Jade, I will be having a vault smear on 4th April which is about 6 months post rad hyst.  The consultant also told me I would have a MRI in Oct. 

I asked my GP what I should be looking out for if it was to come back and she said abnormal bleeding, abnormal discharge, vaginal pain that is inside like period pain and a swollen groin/pelvic area with poss lumps. However, she did stress that these symptoms wouldn't necessarily mean it had come back just that they would want to check it out.

I'm with you in that I'd want every possible test going and I'm glad I'm getting the vault smear.  I'll ask my consultant more about it when I go and will report back so you have the info in advance of your appointment.

Hugs, Cheryl, xx

Hi Lea, I have my check up on Monday too! It's my 1 year post surgery check up.

If it's like mine they use a speculum and take a look, then perform a manual exam using thier fingers to feel for any changes. The consultant usually asks about your bowel, bladder, if you've tried intercourse etc but it's a really quick internal exam.

No need to be scared really, it's not overly invasive compared with what you've already been through. I told the consultant last time that I was pretty nervous, and she was great about it and put me at ease.

Hope if goes well for you on Monday xx



Hello all.  I'm 15 months post op and active treatment ended in July 2013.  I hadn't evern heard of a vault smear until recently, having read about it on here.  I just thought that smears were no longer possible because I've no cervix now.  

I've had 2 scans & 2 check-ups since treatment ended, everything looking good I'm glad to say, but I shall mention the vault smear on my next appointment as I'm curious now.  

On a separate note, can I ask the ladies about staging. Some say they are 1b grade 3 for example.  What does the grading refer to? is it CIN grading? I must seem a bit thick after being on here so long but I've not been 'graded' if you know what I mean, just staged.



Hi Sharon

The staging relates to the location and size of the tumour.  For example, my stage 1b1 means it was in the cervix and not over 4cm.  If it had been 1b2 the tumour would have been over 4cm.  There is a full list of stagings and their meanings on the Macmillan site.  Haven't looked on this site so don't know if they are there too.

Incidentally, the vault is the space at the top where the cervix used to be.

Hope that helps.


Hi there,

I think the grading is the grade of the cancer and how differentiated it is compared to a normal cell. So you have staging for the size and spread but then also a grade.

This is from the NHS website on grading:


The grade of a cancer depends on what the cells look like under a microscope.

In general, a lower grade indicates a slower-growing cancer and a higher grade indicates a faster-growing one. The grading system that’s usually used is as follows:

  • grade I - cancer cells that resemble normal cells and aren't growing rapidly
  • grade II - cancer cells that don't look like normal cells and are growing faster than normal cells
  • grade III -  cancer cells that look abnormal and may grow or spread more aggressively


Hi Ladies

Just copied and pasted this from the Macmillan site.

Stage 1

The cancer cells are only within the cervix. Stage 1 can be further divided into:

Stage 1A

The cancer can only be seen with a microscope or colposcope.

Stage 1A1

The cancer is 3mm or less deep and 7mm or less wide.

Stage 1A2

The cancer is between 3–5mm deep and 7mm or less wide.

Stage 1B

The cancer growth is larger but still confined to the cervix.

Stage 1B1

The cancer is not larger than 4cm.

Stage 1B2

The cancer is larger than 4cm.

Stage 2

The cancer has spread into surrounding structures, such as the upper part of the vagina or the tissues next to the cervix. Stage 2 can be further divided into:

Stage 2A

The cancer has spread into the upper part of the vagina.

Stage 2A1

The tumour size is not larger than 4cm.

Stage 2A2

The tumour size is larger than 4cm.

Stage 2B

The cancer has spread into the tissues next to the cervix.

Stage 3

The cancer has spread to areas such as the lower part of the vagina, or the tissues at the sides of the pelvic area. Stage 3 can be further divided into:

Stage 3A

The cancer has spread into the lower part of the vagina.

Stage 3B

The cancer has spread through to the tissues at the sides of the pelvic area and may be pressing on one of the ureters (the tubes urine passes through from the kidneys to the bladder). If the tumour is causing pressure on a ureter, there may be a build-up of urine in the kidney. 

Stage 4

The cancer has spread to the bladder or bowel or beyond the pelvic area. Stage 4 can be further divided into:

Stage 4A

The cancer has spread to nearby organs, such as the bladder and bowel.

Stage 4B

The cancer has spread to distant organs, such as the lungs, liver or bone.

Your doctors may use the following terms to describe your cancer:

  • Early-stage cervical cancer - this usually includes stages 1A to 2A.
  • Locally advanced cervical cancer - this usually includes stages 2B to 4A.
  • Advanced-stage cervical cancer - this usually means stage 4B.  

If the cancer comes back after initial treatment, this is known as recurrent cancer


Thank you ladies. I’m the same as you Jo no scans or anything!

Cheryl, that would be really helpful thank you. If they refuse, I will pay privately to get one done as I’d feel better getting it! Xxx

Hello Chery, thanks for the info, I have seen this but was confused when the ladies talked about ''grades'' as it doesn't mention that specific term here.  

I take it the grade is the number at the end of the stage eg 1B2  - 1B being the stage,  2 being the grade?


Hi, i think that the ending is sub staging if that makes sense. The gradeis what the pathologists do when theytake away te tumor. If you havnt had an op then they cant do that because youve been treated by cemo/rads. I think thats correct but knowing me ill be wrong lol. Youve had an op so you should be able to find out the grade of cancer as it will have been examined. I for one wish i didnt know as it was the most aggressive grade 3. Lea xx



Im gonna ask today as ive got my 3 month check. I will put the answer on later as to why i wont get follow up vault smears or scans. Jo gl for taday hun. Lea xxx



I didnt realise there was a different grade.  I wasnt told anything and it wasnt in my letter afterwards.  Going to ask my consultant about it on 4th April.

Just shows how valuable this site is for finding out information that you never get told.


hi all

i have been told that i will have a vault smear at some point because i had scar granulation.  i will also be having an MRI at 12 months.  At that point i go to 6 month check ups and am then signed off at 2 years.

shows the inconsistencies amongst the NHS trusts.